Speaker’s Statement

Lindsay Hoyle: I have a short statement to make about the new pass reader voting system. New, upgraded pass readers have been installed in the Division Lobbies and will be in use from today’s sitting. Colleagues will notice that the pass reader screens will change from purple to white when a Division is in progress. Hon. Members should tap their pass to record their name only when the screen indicates that a Division is in progress. If any Member has not yet registered their pass to work with the new pass readers, they should contact the Public Bill Office as soon as possible. I remind the House that the new system will be effective tonight.

Oral
Answers to
Questions

Home Department

The Secretary of State was asked—

Asylum Seekers: Hotel Accommodation

Esther McVey: What plans she has for hotels used by her Department to accommodate asylum seekers.

Priti Patel: The Department has long-term plans and proposals to change the way we accommodate asylum seekers.

Esther McVey: Residents of Tatton are concerned about the ongoing nature of supposedly temporary accommodation for immigrants who arrive in the local area. Some hotels are becoming full-time immigration centres and those residing there are in limbo in our town centres. What is the timescale for processing these individuals and for reverting the accommodation back into hotels?

Priti Patel: My right hon. Friend is absolutely right in her comments. Through changes linked to the new plan for immigration we will end the use of hotel accommodation for asylum seekers, which was a result of the pandemic—we had to take decisive action to ensure that those seeking asylum in the UK were protected under covid measures. It was a short-term solution and the new plan for immigration includes long-term changes in the offing for asylum accommodation.

Andrew Gwynne: One big reason why we need to use hotels is that the asylum processing system has basically imploded. The share of applications that received an initial decision within six months fell from 87% in 2014 to just 20% in 2019. What is the Home Secretary’s explanation for that?

Priti Patel: There are a number of factors in terms of why there has been slowing down in the processing of asylum claims. In particular, because of the covid pandemic last year, decisions were not made and we had to change our accommodation policies in the light of Public Health England guidance, which is well documented and well known. That has put pressures on the wider system. Of course, the hon. Gentleman will be well aware of the proposals in the new plan for immigration on not only processing, fast-track removals and the changes we are making in legislation, but the digitalisation of the system. We will move from paper-based decision making to digitalisation and that work is already in train.

Philip Davies: Asylum seekers are given somewhere to live while their application is being processed, along with £39.63 per person to pay for food, clothing and toiletries. It says on the Government website:
“If you’ve been refused asylum”
you will still be given somewhere to live and still be given
“£39.63 per person…for food, clothing and toiletries”.
Why on earth is the state still providing accommodation and money for people who have been refused asylum? Surely that is when Government support should be turned off.

Priti Patel: If my hon. Friend has read the new plan for immigration and the Nationality and Borders Bill, it will be abundantly clear to him that changes will be coming forth that will absolutely put an end to that.

Stuart McDonald: We agree that hotel use should end, but we should go back to the community dispersal of asylum seekers throughout the country. We need to ditch this ludicrous and dangerous idea that hotels are some sort of luxury for asylum seekers, because for very many of them the opposite is the case. The Home Secretary knows that the increased use of hotels has seen increased deaths in the asylum accommodation system. Why is the Home Office still placing large numbers of asylum seekers in unsuitable hotels in inappropriate locations, without so much as notifying the relevant local authority, never mind seeking its agreement or ensuring that appropriate levels of support are in place?

Priti Patel: The answer to the hon. Gentleman’s question is, of course, because local authorities around the country, and particularly in Scotland, have not played their part in helping with dispersal accommodation. The hon. Gentleman should be ashamed of himself for coming to the House and making that point when the Scottish Government have done absolutely nothing to lift a finger in supporting the policy of dispersal accommodation. [Interruption.] In response to the hon. Member for Birmingham, Yardley (Jess Phillips), the answer in relation to Birmingham is because the rest of the United Kingdom is not playing its part.

Stuart McDonald: That is one of the most outrageous answers that this incredible Home Secretary has ever given. Every single local authority in Scotland is anxious to play its part in resettling refugees. When it comes to dispersal accommodation, Glasgow has stepped up to the plate while other local authorities are withdrawing from the scheme, and they are doing so, quite rightly, because the Home Office refuses to put in place the support that is required to encourage them to do that. Instead of community dispersal, the Home Office is planning to press ahead with large-scale warehousing of asylum seekers in Napier-style accommodation centres. That is worse even than hotels. Will she confirm that the Home Office will, at the very least, seek local authority permission for building these centres in the middle of people’s local authorities and will not seek to bypass local democracy, as it did with Napier barracks?

Priti Patel: We on the Conservative side of the House will take no lectures on bypassing democracy or local councils. For the record, 31 local authorities out of 32 in Scotland have refused to participate in the dispersal scheme. I say to the hon. Gentleman and to all Members of the House that, when it comes to changes to asylum accommodation, the whole of the United Kingdom needs to step up and play its part. That is how we will  address the long-term issues with accommodation more widely. [Interruption.] I can hear the hon. Gentleman say, “You need to play your part.” On the funding side of matters, it is absolutely correct to say that the Home Office, working with the former Ministry of Housing, Communities and Local Government, has been doing everything possible to provide local authorities with financial support and assistance, but certain councils around the country still say no.

International Workers with STEM Qualifications

David Davis: What steps her Department is taking to attract international workers with science, technology, maths and engineering qualifications to the UK.

Priti Patel: Attracting international talent is a key component of our global, points-based immigration system, delivered as we promised the British public at the 2019 election. This system is designed to attract global talent, sponsored by employers, bringing the best scientists, engineers, academics, and other people with skills to our country.

David Davis: Last week, I met the chief scientific adviser, Sir Patrick Vallance, to discuss the challenges facing Britain as we seek to become a leading science superpower. He spoke of the need for cross-departmental support, including from the Home Office, to ensure that Britain is competing in the marketplace of global excellence. Can my right hon. Friend update the House on what conversations her Department has had with UK Research and Innovation with respect to the global talent visa route, and how well she expects it to work?

Priti Patel: This is an important area in developing global talent and making sure that we, as a country, are attractive and can become the science superpower that we aspire to be. The chief scientific officer has indeed been leading this work with the Home Office and with the Treasury. In response to my right hon. Friend’s question, I can say that there is a great deal of work taking place, that these routes are open and that he will hear a lot more about the applications and the numbers that are coming through, but I can assure the House that the Home Office and this Government are absolutely dedicated to making sure that we get the brightest and the best over to our country through this new route.

Preventing Violence Against Women and Girls

Rachael Maskell: What steps she has taken to support local partnerships to help prevent violence against women and girls.

Rachel Maclean: Our strategy is a whole-system approach, with different local agencies—for example, the police, healthcare and social care—working together to ensure more effective interventions. To that end, we have put in place guidance, training and online resources for the police and healthcare and educational professionals, and we will shortly be refreshing our national statement of expectations to support local areas in commissioning services.

Rachael Maskell: The unacceptable and continued prevalence of misogyny and violence against women and girls highlights the need for multi-agency partnerships, but the funding is woeful, yet the challenge is great. Will the Minister ensure that the police, who are ever focused on crime detection rather than crime prevention because of the lack of resources, have the resources at hand to build the multi-agency partnerships that are vital to change the culture?

Rachel Maclean: I reject what the hon. Lady says about funding and resources. In her area, the police are receiving their fair share of the 20,000 additional police officers we have pledged to hire. She will already see 114 additional officers in her area, and the police are receiving up to £171.7 million of funding—an increase of £5.5 million—so I suggest that she talks to her local police and crime commissioners and ensures that they are prioritising that funding in the right way.

Alun Cairns: Domestic violence is one of the ugliest and saddest outcomes of some of the measures that the Government were forced to introduce to handle the covid pandemic, but may I draw the Minister’s attention to the excellent work of the domestic abuse charity Atal y Fro in my constituency, which has encouraged GPs to follow the IRIS—identification and referral to improve safety—programme, enabling them better to identify some of the more prevalent symptoms among victims of domestic violence?

Rachel Maclean: I thank my right hon. Friend for drawing the attention of the House to that excellent programme, which highlights the important role that frontline GPs have in identifying and getting help to victims. I have been informed that he ran the London marathon to raise funds for a charity in his area. I congratulate him on all the hard work that he is doing; I am sure that those services will benefit enormously.

Jess Phillips: I have a point about the funding. The Randox contract that was granted without any tender is five times the amount that we spend on domestic violence refuges for the entire country—just FYI.
In September, Her Majesty’s inspectorate of constabulary and fire and rescue services published a report making clear the current failings, and pushing for the implementation of its urgent recommendations to improve our national response to violence against women and girls. On 22 September, 18 October and 8 November, I asked the Minister if and when the Government would implement the recommendations in full. I am at risk of sounding like a broken record, as I ask again now: will the Minister today commit to keeping to the very detailed action plan commanded by the inspectorate within the timescale that it states? I do not want to hear again, or in a few weeks’ time, that the Department is still looking closely at the recommendations. Will she commit to them today?

Rachel Maclean: If I may just make a point on funding, I am sure that the hon. Lady would welcome the fact that the Government are providing £300 million of support for victims and witness support services this year.

Jess Phillips: Half the amount of the Randox contract.

Rachel Maclean: No, that is not relevant. This is a very important subject, and victims and support services deserve to know that this Government are on their side.
Let me turn to the report referenced by the hon. Lady. This is not a broken record. These are the facts: we are responding and taking action, which is why the Home Secretary is leading on a ministerial group across Government, bringing together the whole of Government to bear down on the recommendations outlined in the report—[Interruption.] Perhaps the hon. Lady would like to listen to the Minister. We have also appointed Maggie Blyth to lead the work across the entire police force and criminal justice system that will focus on addressing violence against women and girls, which is a priority for this Government.

Channel Crossings

Edward Leigh: What progress her Department has made on tackling illegal migrant channel crossings.

Priti Patel: The UK Government are addressing the challenge of illegal migration for the first time in decades through comprehensive reform to break the entire business model of people smuggling. For the first time, whether someone enters the UK legally or illegally will have an impact on how their asylum claim is processed and on their status in the UK if that claim is successful.

Edward Leigh: At the referendum, us Brexiteers told the people that we would take back control. It is clear that, in this aspect, we have lost control. If we tell the most desperate economic migrants in the world, “We will provide a free border taxi service across the channel, we will never deport you and we will put you up in a hotel for as long as you like”, is it any wonder that more and more come? This is now a national emergency. Will the Home Secretary introduce an emergency powers Act to override the Human Rights Act, if necessary, and put people in secure accommodation now? Otherwise, we will not solve the problem.

Priti Patel: My right hon. Friend will be well versed in the work that we are doing through the Nationality and Borders Bill, which speaks to the points that he has been making about asylum, processing, deportation and fast-track removals, and which, importantly, will ensure that we break the business model of traffickers who are smuggling people into the United Kingdom. I have always said—

Lindsay Hoyle: Order. Home Secretary, it is easier if you face the Chair, not the right hon. Member for Gainsborough (Sir Edward Leigh)—just to help each other.

Priti Patel: My apologies, Mr Speaker.
As I was saying, the new plan for immigration and the Nationality and Borders Bill are pivotal to the comprehensive reform of the entire system. There is no single solution, which is why the Bill is so important. I know that all hon. Members on the Government Benches will back the Bill, in stark contrast with those on the Opposition Benches.

Online Fraud

James Davies: What steps her Department is taking to tackle online fraud.

Damian Hinds: Online fraud can cause very serious harm to victims, both financial and emotional. We are determined to protect the public from these crimes and to go after those that commit them. The draft Online Safety Bill will be one important tool to enhance our abilities in that.

James Davies: I thank my right hon. Friend for that update. Ofcom allows those who receive spam text messages to forward them to a service, 7726, to report the receipt of those messages. How will the law enforcement agencies use the data acquired to locate and to punish the perpetrators of those crimes?

Damian Hinds: I am grateful to my hon. Friend for highlighting the 7726 service, because referrals to that help to build up the intelligence on SMS fraudsters or scam texters and can help to lead to take-downs. It is really important that law enforcement works both with regulators and directly with individual telecoms companies to protect victims and go after the criminals responsible.

Modern Slavery Offences

Carolyn Harris: What recent assessment she has made of trends in the level of suspected modern slavery offences.

Rachel Maclean: Modern slavery is a truly awful crime. Statistics for England and Wales show that police-recorded modern slavery offences increased by 2% in the year to June 2021, and live investigations also increased from 188 in December 2016 to 3,869 in October 2021. We are committed to tackling modern slavery and we have invested £15 million to strengthen the police response over the past five years.

Carolyn Harris: Prosecution and conviction rates of perpetrators of modern slavery are surprisingly low. Evidence from Justice and Care’s victim navigator programme shows that with appropriate support more victims would have the confidence to help investigations, resulting in more prosecutions. Will the Minister please consider giving all confirmed victims at least 12 months’ support in the country so that they can feel empowered to engage with the justice process?

Rachel Maclean: I thank the hon. Lady for her question; she has highlighted an important issue. The whole point of our modern slavery strategy is to be able to track down and prosecute those horrendous criminals who heartlessly traffic human beings into this country. The entire force of the Government’s policy making is devoted to that end.

Jacob Young: Many people who are victims of modern-day slavery are those who have been illegally trafficked into this country across the channel. What are the Government doing to break up the criminal gangs dangerously smuggling people across the channel and bring an end to these illegal crossings?

Rachel Maclean: I thank my hon. Friend for highlighting that. There are a range of measures in the Nationality and Borders Bill. I very much hope that Opposition Members will support those measures so that we can break down these criminal gangs. We are also working very closely with the police and we have invested additional funds in our courts system to catch up from the backlog of the pandemic.

Holly Lynch: I have heard what the Minister has said, and we can all agree that perpetrators of modern slavery are committing heinous crimes and must be brought to justice. With that in mind, I wonder whether Government Ministers have read the independent anti-slavery commissioner’s recent article entitled “Rushed borders bill will fail victims of modern slavery”. Will the Government urgently act to address the failings in the Nationality and Borders Bill before it effectively tears up the Modern Slavery Act 2015, letting down victims and letting perpetrators get away with their crimes?

Rachel Maclean: I can assure the hon. Lady that I meet the independent anti-slavery commissioner and she plays a very important role in informing the Government’s policy. I can also assure her that the Nationality and Borders Bill is going to strengthen the Government’s response and support for the victims of modern slavery. We have a world-leading system to support and protect victims of modern slavery that we have backed with significant Government resources and investment. The legislation that we are passing will enable us to respond more compassionately to those victims.

Peter Bone: While the Minister is absolutely right to say that we lead Europe on modern-day slavery, the question asked by the hon. Member for Swansea East (Carolyn Harris) goes very much to the heart of the matter: if we want more prosecutions, we need more victims to come forward. The way to do that is that if they are coming into this country irregularly they need a year of leave to remain here so that we can get at these—please excuse this if it is not parliamentary—evil bastards. Will the Minister reply to the hon. Lady’s question: can we have that year?

Rachel Maclean: I can reassure my hon. Friend and all Members in the House that those victims who are working closely with the police and the Crown Prosecution Service are looked at on a case-by-case basis. Where they are assisting the police and the criminal justice system with their inquiries, they are permitted to stay in this country, and our legislation that we are bringing forward will clarify that further. [Interruption.] I have met victims of modern slavery, thank you, I say to the hon. Member for Birmingham, Yardley (Jess Phillips), who is speaking from a sedentary position.

Lindsay Hoyle: Order. Let us try to calm it down. We do not want another week like last week. When Members have asked their question, they do not need to continue.

Rachel Maclean: I hope I have answered my hon. Friend the Member for Wellingborough (Mr Bone). I am happy to speak to him in more detail. I make it clear to the hon. Member for Birmingham, Yardley that I have met victims of modern slavery. I have heard their stories, which are shocking, and we are putting all our efforts into preventing these crimes and dealing with the people who perpetrate them.

Tackling Violent and Sexual Offences

Tony Lloyd: What recent assessment she has made of the effectiveness of her Department’s policies to tackle violent and sexual offences.

Mark Logan: What recent assessment her Department has made of the progress of its tackling violence against women and girls strategy.

Rachel Maclean: Crimes of violence against women and girls are abhorrent and have no place in our society. Maggie Blyth has been appointed as the new policing lead for tackling violence against women and girls. We have launched a £5 million safety of women at night fund, and we will be launching a national communications campaign focused on targeting perpetrators, educating young people and ensuring victims can access support.

Tony Lloyd: The sexual abuse and grooming of our young women and men is a heinous crime, and it is outrageous that victims should come into contact with their perpetrators after those perpetrators are released from prison. Successive Home Secretaries, including the present Home Secretary directly, have promised me that action would be taken where appropriate to deport those perpetrators. Can we know what progress has been made? If there has been no progress, will the Home Secretary agree to meet me?

Rachel Maclean: My right hon. Friend the Home Secretary has indicated that she would be very happy to meet the hon. Gentleman. We all recognise the need to tackle these absolutely disgusting crimes, and I am sure that the whole House would support what he is asking for.

Mark Logan: Drugs, speeding and ineffective response times were top issues at the crime forum I held in Breightmet and Tonge with the Haulgh, but it was violence against women that gave me pause during that event. What is being done to tackle violence against women in Bolton?

Rachel Maclean: I thank my hon. Friend for how he is focusing on this issue. We have a national programme to support women and girls’ safety and, as part of that, Greater Manchester has been awarded £1.5 million from the Home Office’s domestic abuse perpetrator programme fund. The fund works with perpetrators to get them to change their behaviour. It is very difficult but important work, and it is taking place specifically in Bolton. One of the partners is Talk, Listen, Change, which has been accredited by the organisation, Respect, as delivering very high-quality interventions.

Antisocial Behaviour

Ellie Reeves: What recent assessment she has made of trends in the levels of antisocial behaviour.

Rachel Maclean: Police-recorded incidents of antisocial behaviour show a fall from 2.1 million in 2013-14 to 1.8 million in the year to June 2021. The  Anti-social Behaviour, Crime and Policing Act 2014 provides flexible tools and powers for local agencies to tackle antisocial behaviour.

Ellie Reeves: Following Conservative cuts to the policing budget, the police stations in Penge and Sydenham have both closed. Meanwhile, reports of antisocial behaviour locally have been rising, and recently we have seen a sharp increase in thefts from cars. Will the Minister back Labour’s plan to roll out neighbourhood police hubs to help tackle crime and antisocial behaviour and provide a visible police presence, or will she continue to let down our communities?

Rachel Maclean: The hon. Lady will know that our beating crime plan has set out that neighbourhood hubs are an integral part of the response. Policing in London is the responsibility of the Mayor of London. The Metropolitan Police Service is one of the best-funded forces in the whole country, receiving more than £3 billion in 2021-22, an increase of up to £132.4 million. It already has an additional 2,070 officers on the beat.

Jonathan Gullis: Last Thursday evening, I was at the Smallthorne Community Centre with the Smallthorne Village Residents Association, local Staffordshire police officers and police community support officers. One of the biggest issues that came up was the antisocial behaviour of a tiny minority of feral youths. Will the Minister tell me: what are we going to do about those youngsters and their parents, to get them out cleaning the streets and looking after the community so that they can pay back my local community for the lives they are ruining?

Rachel Maclean: My hon. Friend strongly represents the views of his constituents. None of us likes to see that type of low-level disruptive crime, which has a devastating impact on communities. I thank him for championing his police force. Our neighbourhood crime plan is an integral part of tackling such crimes.

Sarah Jones: Antisocial behaviour is blighting communities: it has gone up by a woeful 70% across the country in the last year. Since the Conservatives took power, twice as many people say that they never see a police officer on the street. The Leader of the House said:
“I have often found…that a quiet word from a police community support officer can nip…antisocial behaviour in the bud.”—[Official Report, 13 May 2021; Vol. 695, c. 273.]
We totally agree. Will the Minister restore some of the 50% of PCSOs whose posts the Government have cut?
Before the Minister says that she is recruiting 20,000 officers, let me point out that we know that only 400 of the first tranche of 6,000 are in neighbourhood roles. Will she give victims of antisocial behaviour the same rights as other crime victims—if the Government ever get round to publishing the victims Bill—or do they still think that what she describes as “low-level” antisocial behaviour is not worth tackling?

Rachel Maclean: The hon. Lady has taken my words out of context. Neighbourhood crime encompasses a vast spectrum of crimes that have a considerable impact on local communities, as I made clear at the Dispatch  Box earlier. Those are a range of crimes that are at the centre of the Government’s response in our beating crime plan. We have made it clear that increasing the number of police officers on the beat is a priority. We are already more than halfway through our plan to deliver an additional 20,000 police officers on the street. The neighbourhood crime plan is part of our plan. It is for local forces to determine the operational priorities in their areas.

Afghan Citizens Resettlement Scheme

Helen Hayes: What progress she has made on the implementation of the Afghan citizens resettlement scheme.

Victoria Atkins: Through the Afghan citizens resettlement scheme, the UK will relocate up to 20,000 at-risk people in the coming years. We are working urgently across Government and with partners such as the United Nations High Commissioner for Refugees to design the scheme. We continue to support the thousands of people successfully evacuated from Afghanistan under Operation Pitting, and we will continue to support those who come under the scheme when it opens.

Helen Hayes: It is now almost exactly three months since Operation Pitting came to an end. My constituent continues to update me on the situation facing her brother, who is in hiding in Afghanistan with his wife, mother and three small children. Since the evacuation ended, they have lost an uncle and a cousin, both murdered by the Taliban, and they have received numerous threatening messages. They live in daily fear for their lives, yet the Government will not issue papers to give them the best chance of safe passage to the UK via a third country. Does the Minister have any regret that we are three months on and the scheme has not yet opened? When will she give some hope to people in such desperate circumstances as my constituent’s family?

Victoria Atkins: The hon. Lady has articulated the real dangers that many are facing in Afghanistan; I think we can all agree on that. The reality is, however, that the ever-changing security situation in Afghanistan means that we still have no UK consular presence or Army presence there. That is something that we and other countries around the world that are trying to help Afghan people are having to grapple with. We are working at pace and we want to set the scheme up as an example of a safe and legal route under the Government’s new plan for immigration.

Bambos Charalambous: Since mid-August, Germany, a country that has not had the military and overall engagement of the UK in Afghanistan, has flown more than 6,000 Afghans to Germany and provided them with protected status under its humanitarian admission programme. Can the Minister tell me what conversations she has had with counterparts in the European countries running such schemes to help to enable the quicker opening of the Afghan citizens resettlement scheme? There is a real risk that the people whom the scheme is intended to help will die before it becomes operational.

Victoria Atkins: I know the hon. Gentleman well, and I know that he will not have overlooked the 15,000 people whom we evacuated during the emergency conditions of Operation Pitting. Of course, there are still agreements carrying on with third-party countries for evacuating people—where it is safe to do so, where checks have been conducted and so on—each and every week. Not only do we have the ACRS in the process of being built, but we are meeting our commitment to those who have worked with the UK Government and the UK Army under the Afghan relocations and assistance policy, so work is ongoing to protect people. We are working with international partners; indeed, I met the German delegation during the Conservative party conference to discuss with them the work the Germans are doing. However, we are very much in the hands of our international partners when it comes to opening up safe and legal routes through Afghanistan to us.

Special Constables

Siobhan Baillie: What steps her Department is taking to support special constables.

Kit Malthouse: I am sure you agree with me, Mr Speaker, that special constables are among the most remarkable citizens in the land. We are bringing forward legislation to enable them to become members of the Police Federation, so that they can access the same support and protection as regular officers. We will also be introducing the police covenant in legislation shortly to ensure further support and protection for the police workforce, including special constables.

Siobhan Baillie: I thank the Minister for his answer. Special constables are often on shift during the busiest periods, as they tend to volunteer at weekends and in the evenings, and as a result are exposed to quite high levels of trauma. I give credit to the Stroud special constables, and ask what my right hon. Friend is doing specifically and actively to support their training for and meet the mental health needs of their unique roles?

Kit Malthouse: I am grateful for the fact that the welfare of this special—in every sense of the word—group of people is at the forefront of my hon. Friend’s mind. She will be pleased to know that the Government continue to fund the national police wellbeing service, which provides support and particularly post-traumatic incident services to all police officers, including special constables. As I said in the earlier part of my answer, there is more that can be done, and by making sure that all special constables are full members of the Police Federation, they will be able to access the significant support that that organisation can provide.

Antisocial Behaviour

Kim Leadbeater: What steps she is taking to (a) tackle antisocial behaviour and (b) support victims of antisocial behaviour.

Rachel Maclean: The beating crime plan laid out the Government’s commitments to working with local agencies to drive down antisocial behaviour, and we are committed to ensuring that victims of antisocial   behaviour get the response they deserve. The Anti-social Behaviour, Crime and Policing Act 2014 introduced specific measures designed to give victims and communities a say in the way that complaints of antisocial behaviour are dealt with, and this includes the community trigger—an important safety net that gives victims of persistent antisocial behaviour the ability to demand a formal case review.

Kim Leadbeater: Does the Minister agree with me that if her Department was fit for purpose, local councillors in my constituency from her party as well as from mine would not be forced to find the funding for neighbourhood policing after 11 o’clock at night, because Government cuts have left the hard-working officers I have met so overstretched in the fight against crime and antisocial behaviour?

Rachel Maclean: I am sure the hon. Member will agree that local councillors of all parties want to tackle the scourge of antisocial behaviour that affects their residents. Local areas have the powers and the funding from the Home Office. The Mayor of West Yorkshire, a Labour Mayor, is receiving up to £510.8 million of funding, which is an increase of £25.8 million on the police settlement of last year, and she has also been able to recruit an extra 619 officers to tackle these priorities.

County Lines Drugs Gangs

Cherilyn Mackrory: What progress her Department has made on tackling county lines drugs gangs.

Danny Kruger: What progress her Department has made on tackling county lines drugs gangs.

Kit Malthouse: The Prime Minister issued an instruction that we should roll up county lines, and that is exactly what we have been doing for the last two years. Since 2019, we have invested over £65 million, including over £40 million committed this year. This has already resulted in the closure of more than 1,500 lines, over 7,400 arrests and the safeguarding of more than 4,000 vulnerable adults and children.

Cherilyn Mackrory: I thank the Minister for his answer. I was very pleased, recently, that a county lines dealer who had been flooding towns across Cornwall, including Truro, with drugs was jailed for five and a half years. There is a lot more to do in Cornwall, because we are seeing an increase in the impact of county lines drugs activity and all the crimes that go with it. Can the Minister confirm that the Government are aware of the issues in Cornwall and assure me that they are committed to working with our brilliant police and crime commissioner, Alison Hernandez, and the six Cornish MPs to address the continued problems, in particular how the Government can support the wider roll-out of Project ADDER?

Kit Malthouse: I am focused on the impact of drugs across the whole country, and particularly in areas such as Devon and Cornwall, where I know the chief constable, and Alison Hernandez, the police and crime commissioner, have been doing an enormous amount of work. This problem is so prevalent across the United Kingdom that every part has to work together, and I am pleased  that Devon and Cornwall Police have been working closely, particularly with the Metropolitan Police and Merseyside Police, which are the two key exporting forces for drugs into my hon. Friend’s area. She might be interested to know that recently the British Transport Police, which plays a critical part in gripping the network that distributes the drugs, conducted a fixed-point pilot at Basingstoke Station. It intercepted drugs that were heading towards her constituency, and I hope she will soon feel the effects of that.

Danny Kruger: May I echo the point made by my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory)? There have been very successful disruptions to county lines in my Wiltshire constituency, and I pay tribute to Philip Wilkinson, the police and crime commissioner, and to Wiltshire Police. It is great that they can work in partnership with all the Conservative PCCs across our region, and with the Government. The challenge now is to move one level down, below the cities to the market towns and rural areas, which is where the problem with drugs really manifests itself in my area. Will the Minister continue the efforts on county lines, and ensure real support for local efforts at disruption, not just at regional level?

Kit Malthouse: My hon. Friend is exactly right, and as my constituency neighbour he feels the same impact on our rural towns and villages as I do. He is right: as I said earlier, this is such a comprehensive problem that market towns and villages must work with large urban areas, and we have to grip the transport network in between. Particularly key is that we aim to take out those who perpetrate this “business” while sitting in the comfort of their homes in a city. The great development in our effort against county lines has been the ability of the police in Liverpool, west midlands and London—the three big exporting areas—to find those guys and take them out.

Refugees: UK Resettlement Scheme

Munira Wilson: What progress she has made on resettling refugees under the UK resettlement scheme.

Kevin Foster: We have been welcoming refugees through the UK resettlement scheme since its launch in March 2021. That commitment will ensure that we continue to offer safe and legal routes to the UK for vulnerable refugees in need of protection, with our focus firmly on helping people from regions of conflict and instability directly.

Munira Wilson: I am proud that Liberal Democrat-run Richmond Council, and many of my constituents, stated early during the Afghan crisis that refugees are welcome in our borough, and that they would work hard to support and rehouse those evacuated. Over the past few weeks some £6,500 has been spent on family homes for evacuees from Afghanistan, but as yet no families have been resettled in those homes. Not only is that a waste of taxpayers’ money, but presumably there are many families in unsuitable hotel accommodation. What is the Minister doing to ensure that families who have been evacuated will be resettled quickly where accommodation is available?

Kevin Foster: The comments by Richmond Council certainly contrasted with the approach that the Lib-Dem leader of Torbay Council took when first asked to take part in the Afghan resettlement scheme, but it made a welcome U-turn and we will play our part. Work is being done across the Government to support those who arrived as part of the emergency evacuation back in August, and those who will arrive under the resettlement scheme, to ensure they can be housed quickly.

Removal of Illegal Migrants

Tom Hunt: What steps she is taking to speed up the removal of illegal migrants.

Tom Pursglove: Our new plan for immigration makes it easier to remove illegal migrants who have no right to be here. The one-stop process that we are introducing through the Nationality and Borders Bill will be fundamental to delivering on that in future. The Home Secretary has also been setting up a mix of formal and informal returns agreements with other countries, in order to tackle the drivers of illegal migration. Examples of that work include our new formal arrangements with India and Albania.

Tom Hunt: Does the Minister agree that when millions of people voted to leave the European Union, they did so to take back control of our borders—no ifs, no buts—and on our own terms, not only if the French agree? Does he also agree that, in a spirit of taking back control, we need to intensify our movements towards offshore processing, which we know was successful in Australia where, when it was introduced, the numbers fell of a cliff straightaway?

Tom Pursglove: I am grateful to my hon. Friend, who is a passionate advocate for his constituents on this issue. I, too, was on the frontline of that campaign in 2016, and I am very sympathetic to the point that he makes. There is no one single solution to this problem. The measures that we are introducing through the Nationality and Borders Bill are comprehensive, but we also need that co-operation with our French partners, and to tackle this issue upstream.

Channel Crossings

Philip Hollobone: What steps she is taking to (a) prevent and (b) speed up the removal of illegal migrants using small boats to cross the channel; and what recent representations she has made to her French counterpart on intercepting attempted small boat crossings.

Tom Pursglove: Our Nationality and Borders Bill sets out comprehensive measures to deter illegal crossings, tackle the criminal gangs responsible and protect lives. We are using all available options to bring crossing numbers down. The Home Secretary and the French Interior Minister agreed to accelerate the delivery of their joint determination to prevent all crossings and make this deadly route unviable.

Philip Hollobone: Given that we have given tens of millions of pounds to the French, including in night-vision equipment, automatic number plate recognition technology and access to drones, is it not completely disgraceful for large groups of French police to be pictured on the beaches in France waving large boats of migrants across the channel, as we have seen in recent days? If we are giving the French this money, please can we insist that they use it to stop this illegal flow?

Tom Pursglove: I am grateful to my hon. Friend and neighbour for his question. The Home Secretary had a constructive conversation last week with the French Interior Minister. He has repeatedly said that the determination is to stop 100% of these crossings. We entirely support that endeavour, and we must work towards that end. Clearly, the policing response on French beaches is integral to that, but it is also welcome that, for example, there has been a greater effort to disband some of the camps that we have seen around beaches.

Topical Questions

Tim Farron: If she will make a statement on her departmental responsibilities.

Priti Patel: The kidnap, rape and murder of Sarah Everard by a serving police officer was devastating. I am launching an independent inquiry into exactly what happened, and I am pleased to confirm to the House that the right hon. Dame Elish Angiolini QC has agreed to be the chair of that inquiry. Dame Elish is an exceptionally distinguished lawyer, academic and public servant. Her extensive experience includes a review of deaths in police custody, as well as a review for the Scottish Government of the handling of complaints and alleged misconduct against police officers.
The inquiry will be made up of two parts. Part 1 will examine how this monster was able to serve as a police officer for so long and seek to establish a definitive account of his conduct. The independent police inspectorate is already looking at vetting and counter-corruption capability, which will enable the inquiry to examine vetting and re-vetting procedures in detail, including his transfers between forces. Part 1 will also seek to understand the extent to which his behaviour rang alarm bells with his colleagues. The chair will report to me as soon as is practical. The Home Office will then publish the report, and I will set out the terms of reference for part 2, which will consider the broader implications for policing arising from part 1.
The inquiry will begin as a non-statutory inquiry, because I want to give Sarah’s family closure as quickly as possible. As Members know, statutory inquiries can be long-running, with limited flexibility; sometimes, recommendations are not made for a number of years. However, I will not rule out converting this inquiry to a statutory footing should Dame Elish feel that she is unable to fulfil the terms of reference on a non-statutory basis.
Sarah Everard’s life was ended too early by an evil man whose job it was to protect her. We owe it to her, and to her loved ones and her family, to prevent something like this ever happening again.

Tim Farron: I thank the Home Secretary for her reply, and I very much welcome what she has said at length.
Eighty per cent. of the working-age population living in the Lake district already works in hospitality and tourism. The Home Secretary will see that there is therefore no reservoir of domestic labour available to fill the gap left by her restrictive new visa rules. Will she recognise that we have a special case in the Lake district? We are the biggest visitor destination in the country outside of London, with one of the smallest populations. Will she meet me, and tourism industry chiefs in the lakes and the dales, so that we can come up with a youth mobility visa with European countries to solve the problem and get our economy working again?

Priti Patel: I thank the hon. Gentleman for his question. I would like to praise his hospitality sector. He represents a very beautiful part of the country. Of course, we want hospitality and tourism to thrive across the United Kingdom. I would be delighted, together with my colleagues, to meet him and his hospitality sector. Youth mobility is not just an EU matter; it is now a global matter. There is a great deal of work taking place on youth mobility schemes, including work that we are doing with countries outside the EU.

Sheryll Murray: Earlier this month, I met many of my local farmers through the National Farmers Union. They need agricultural workers and simply cannot fill vacancies from the domestic market. What work has my right hon. Friend done with the Department for Environment, Food and Rural Affairs on a solution to this issue, so we can all enjoy these farmers’ excellent Cornish produce?

Priti Patel: My hon. Friend is right to highlight her farmers’ excellent Cornish produce; I have sampled much of it, through her. First and foremost, through our reforms to the immigration system, there are routes in place already to provide support to the agriculture sector. I have been working with colleagues in DEFRA on that. She will be very familiar with the seasonal agricultural worker pilot scheme; as she will recall, we have increased the number of people who, through that scheme, can work in key agricultural sectors. Finally, she will be aware that a great deal of work is taking place in DEFRA to ensure more investment in people in the domestic labour market, so we are investing in skills.

Nick Thomas-Symonds: I welcome the appointment of the chair of the inquiry set up following the terrible Sarah Everard case, but I say to the Home Secretary: put it on a statutory footing now. The Daniel Morgan inquiry was on a non-statutory basis, and it still took eight years, so time is not an argument for not doing that.
The year before the Home Secretary was appointed, 297 people risked their life crossing the English channel in small boats. This year, 25,700 have made that perilous journey. The Home Secretary has blamed the French Government for this, and the European Union. Over the weekend, there were even reports that she is yet again trying to shift blame to officials in her Department.   A simple question: why will she not show some leadership and accept the responsibility that lies with her for this dangerous situation?

Priti Patel: First and foremost, on the public inquiry that I have announced on the murder of Sarah Everard, I restate for the record and for the right hon. Gentleman that I will work with Dame Elish. I have also been very clear to Sarah Everard’s parents, who do not want this to drag on. We owe it to Sarah’s family in particular to make sure that the inquiry works for them, and that they are protected throughout the process. I have had conversations and dialogue with them about that.
On channel crossings, leadership absolutely is on the side of this Government. That is why we are bringing forward the new plan for immigration. The right hon. Gentleman will be well aware that crossings do not happen automatically; they happen through migrant movements, and through people smugglers not just in France but further upstream, right back into Africa. A great deal of work is taking place across the whole of Government. Yes, we are trying to stop the crossings and break up the gangs—

Lindsay Hoyle: Order. I call Nick Thomas-Symonds.

Nick Thomas-Symonds: Thank you, Mr Speaker. The Government deal with the French authorities is failing. The Government have closed down safe routes, such as the Dubs scheme, and they have cut the aid budget, which was addressing the reasons why people flee their homes. They do not even have successor agreements in place to the Dublin III regulation. Last week, while chatting to journalists in Washington, the Home Secretary yet again vowed to make the channel crossing route unviable, but nothing happens, and ever more people continue to risk their life. Will the Home Secretary admit that the fact that the Cabinet Office has been brought in to try to sort this out is a sign that she has lost the trust of not only the country, but her colleagues?

Lindsay Hoyle: Order. There are other people in this Chamber who matter. I have granted an urgent question in which most of this can be debated. Come on, Home Secretary.

Priti Patel: Thank you, Mr Speaker. The answer to the right hon. Gentleman’s question is no, throughout.

Edward Leigh: Every time we ask a question about channel crossings, the Home Secretary, whose instincts are entirely sound, refers us to the new legislation. What confidence can we have that when that legislation becomes law, the same human rights lawyers will not sink their teeth into it, leaving us back at square one? If this is such an emergency, why do we not rush the legislation through both Houses now?

Priti Patel: My right hon. Friend makes an important point. That is why the legislation has been put together in conjunction with the Ministry of Justice, which has an important role in working with specialist immigration law firms and changing our laws. He will know the details of the Nationality and Borders Bill and the comprehensive work that is taking place.

Kate Osamor: At the last Home Office questions, I raised the issue  of the hardship that claimants under the Windrush compensation scheme are experiencing. Despite the supposed urgency of this for the Government, the average time that claimants are waiting for their final payment is 434 days. I raised the case of my constituent Anthony Bryan in particular; the Home Secretary told the House that she would meet me to discuss the case, only to revoke the offer later. Will she assure the House that she will fulfil her original promise to meet me? Will she also commit to publishing the guidance on how compensation claims are accelerated?

Kevin Foster: I am certainly happy to look into the matter and meet the hon. Member about the case to which she refers. We have put additional resources into the Windrush compensation scheme team to ensure that we can get the decisions that people deserve.

Christian Wakeford: I strongly welcome the Home Secretary’s decision to proscribe the Hamas terror group in its entirety. That will send the unmistakable message that the UK Government are committed to protecting our Jewish community and combating terrorism. The horrific murder of 26-year-old Eli Kay by Hamas terrorists yesterday in the old city of Jerusalem reinforces the importance of the decision. Will my right hon. Friend confirm that the new designation will ensure that anyone spreading the terror group’s genocidal, antisemitic ideology, including by waving flags, will feel the full force of the law?

Priti Patel: My hon. Friend is absolutely right. He clearly understands the importance and significance of proscribing Hamas in all its forms. When the motion comes to the House for debate this week, I hope that all Members of this House will support it, because clearly inciting and supporting terrorist activity is simply wrong.

Kirsty Blackman: I have raised one constituent’s case with the UK Government 13 times; it relates to the Afghan citizens resettlement scheme. I still do not know whether my constituent’s case is being progressed under the Afghan relocations and assistance policy or ACRS. Neither does he, and nor do his family; they are eligible for both schemes, but we do not know under which one his case is being progressed. Please could the Minister ensure that UK Visas and Immigration has answers  to give Members and our constituents—and that individuals, particularly in Afghanistan, are getting updates about what is happening?

Victoria Atkins: The hon. Lady will know that I cannot answer that question on the Floor of the House, but I am very happy to take the name of her constituent afterwards. I have to emphasise, however, that if people remain in Afghanistan, as I have set out on the Floor of the House and in my “Dear colleague” letter, we simply cannot casework them at the moment in the way that parliamentarians would expect, because of the security situation in Afghanistan.

Craig Williams: I thank my right hon. Friend the Home Secretary for the work that she is doing on prosecuting those who participate in county lines drugs. We need cross-party consensus in dealing with dangerous drug gangs in our country, so does she share my disappointment that the Leader of the Opposition and the shadow Home Secretary are backing a policy of not prosecuting those who are found in possession of class A drugs such as heroin, crystal meth and crack cocaine? May I draw her on the issue, and on our party’s approach to dealing with it?

Kit Malthouse: My hon. Friend is absolutely right. There should be no room for confusion in people’s minds: drugs are bad in all their forms, and this Government will do everything we can to restrict supply and deal with demand.

Abena Oppong-Asare: Sistah Space supports black women and girls who have experienced domestic violence. It is campaigning for Valerie’s law, which would introduce mandatory training for police and other agencies, including on dealing with domestic violence in black communities. Will the Minister meet me and Sistah Space to discuss this important issue before the upcoming petitions debate?

Rachel Maclean: The hon. Lady is absolutely right to highlight the importance of the police force’s response to the domestic abuse of all victims. I will be very happy to meet her.

John Penrose: Does the Home Secretary agree that successive studies, including even the 2017 Lammy review, have concluded that improving trust in—and the legitimacy of—our law enforcement officials and institutions, particularly in communities where those have historically been low, is essential to reducing crime everywhere? What further steps does she therefore intend to take to level up in that vital area?

Kit Malthouse: My hon. Friend is right, and he will know that through the Uplift programme we are pushing hard to increase the diversity of UK policing so that the police force looks like the population whom it seeks to protect and represent. We have instituted a review of vetting across policing and, indeed, wider work on police integrity generally, but we are also talking to police leaders about the signal that they send internally within the force to create a culture that inspires trust and a sense of integrity in the British people. I should add that it is important that the police fulfil the basic expectations of every single subject in this land, and in doing so inspire the trust that my hon. Friend seeks.

Stephen Farry: A harsh winter is about to hit Afghanistan, and the United Nations estimates that 23 million people will be at risk of famine. Surely it is a major dereliction of duty for the Government not to have the Afghanistan resettlement scheme in place. Many people have been left in limbo as a result, and aid agencies are looking for answers in respect of what is going to happen.

Victoria Atkins: I entirely understand the concern of the hon. Gentleman and, indeed, the House about the situation in Afghanistan, but the reality is as it is on the ground. We wish it were otherwise, but it is not, so we are working apace—but carefully—to ensure that when the scheme is launched it works well for the people who are eligible for it and works well over the years in which it will operate. There is, I am afraid, no quick answer to this; we must act carefully, and we must reflect the reality on the ground in Afghanistan.

Gareth Bacon: A few moments ago the shadow Home Secretary, the right hon. Member for Torfaen (Nick Thomas-Symonds), quoted the number of people who had crossed the channel in small boats, and used that number to attack my right hon. Friend the Home Secretary. Can my right hon. Friend confirm that the best way to deal with people crossing to these shores illegally is to support the Nationality and Borders Bill, and will she join me in condemning the Opposition parties who vote against every single measure?

Tom Pursglove: My hon. Friend is, of course, absolutely right. It is particularly staggering that in Committee the shadow Minister, the hon. Member for Enfield, Southgate (Bambos Charalambous), condemned the record of the previous Labour Government, who used to argue that people should not be making crossings of this sort, and that they should claim asylum in the first safe country that they reach. That is exactly what should happen.

Lindsay Hoyle: I call the Chairman of the Select Committee, Yvette Cooper.

Yvette Cooper: There are many reasons why domestic abuse victims may not be able to report abuse and violence straight away, including the fact that that abuse and violence is continuing, but when they do, too often an unfair six-month time limit on prosecuting common assault domestic abuse means that they are denied justice and the perpetrators are let off. I tabled an amendment to lift the limit, and it is being debated this afternoon in the House of Lords. Will the Home Secretary now accept that amendment, and give justice to thousands of domestic abuse victims who are currently being denied it?

Priti Patel: We have always been clear about support for domestic abuse victims. The right hon. Lady will recognise that in the landmark Domestic Abuse Act 2021, the work done in both Houses during its passage, and our response to everyone who has been a victim of domestic abuse. From a policing perspective, I should say that resources are there, and that we are doing everything possible to join up the system with the criminal justice system and the Crown Prosecution Service to ensure that all the necessary support exists for those victims.

Laura Trott: I welcome the Home Secretary’s announcement of the new chair of the Sarah Everard inquiry, but, as has been mentioned, even non-statutory inquiries can be very long. Can the Home Secretary assure us that the necessary steps on vetting and the treatment of and sanctions in relation to sexual misconduct allegations will be taken in the interim?

Priti Patel: Absolutely, and that is why we are pressing ahead with the inquiry on this particular basis. Let me say to all colleagues throughout the House that throughout all the discussions, and in view of the obvious sensitivities surrounding the murder of Sarah Everard, much thought and consideration has been given to the timeframe, but we are looking at the most pressing issues to see what lessons can be learnt and applied to policing as soon as possible.

Joanna Cherry: A number of Government Departments have withdrawn from the Stonewall diversity champion scheme over concerns about the misrepresentation of equalities law and the resultant failure to respect the rights of all protected characteristics. What are the plans of the Home Office in respect of its membership of that scheme?

Priti Patel: I will write to the hon. and learned Lady and tell her what the overall position is across Government.

Marco Longhi: Does the Home Secretary agree that the single most important step any sovereign nation can take in protecting its own borders against illegal immigration is offshore processing?

Tom Pursglove: It is fair to say that, through the Nationality and Borders Bill, we are putting in place a comprehensive package of measures to deal with this issue. Central to that work is the issue of offshore processing, and we reserve the position to do exactly that.

John Cryer: The Home Secretary will be acutely aware that Colin Pitchfork, the double child rapist and murderer, is now back behind bars. The fact that he was released in the first place shows that something is profoundly wrong at the heart of the system. What conversations is she having with the Justice Secretary to ensure that this never happens again?

Priti Patel: This is a very important case, and many conversations are taking place across Government, particularly with the Justice Secretary, the Ministry of Justice and the Parole Board. I cannot add any more than that. Obviously there are some things out in the public domain, but a lot of discussions are taking place right now. This should never happen.

Channel Crossings in Small Boats

Nick Thomas-Symonds: (Urgent Question): To ask the Home Secretary to make a statement on the channel crossings in small boats.

Priti Patel: The number of people coming into our country illegally on small boats is unacceptable. It is the result of a global migration crisis. Just last week, I met my counterparts in the US, who are grappling with similar diplomatic, legal, legislative and operational issues. It is fair to say that in all my dialogues with counterparts and Interior Ministers, including the Polish Interior Minister this morning, similar feedback is taking place across the board.
We would be in a much worse position if it were not for the work already untaken by the Government. We have ensured that the National Crime Agency has the resourcing it needs to tackle and go after the people-smuggling gangs, resulting in 94 ongoing investigations, 46 arrests and eight convictions this year. We have also: reached two new deals with France, putting more police officers on French beaches and introducing new groundbreaking technology to better detect migrants; set up a joint intelligence cell with France to target migrant interceptions on French beaches; introduced new and tougher criminal offences for those attempting to enter the UK illegally; laid statutory instruments to stop asylum claims being made at sea; and agreed returns deals with India and Albania—and had discussions just last week with Pakistan—to take back more foreign national offenders and failed asylum seekers, with more returns deals imminent.
All these measures form part of the new plan for immigration, which I launched in this House in February this year. The remaining components of that plan are currently making their way through Parliament in the Nationality and Borders Bill, and I look forward to working with all colleagues to ensure that it receives Royal Assent as soon as possible. The Bill introduces a range of measures, including but not limited to: a one-stop appeals process; the ability for asylum claims to be heard offshore in a third country; the ability to declare those who arrive in the UK having passed through safe countries where they could have claimed asylum inadmissible to our asylum system, meaning no recourse to public funds and limited family reunion rights; visa penalties for countries refusing to take back their nationals; quicker returns of foreign national offenders; and a new age verification to prevent adult asylum seekers from posing as children.
If any hon. or right hon. Members have concrete proposals that are not already featured in the new plan for immigration, I would be happy to meet to discuss them. My door is always open, particularly to those from the Opposition Benches because of course they attack the new plan for immigration. They have not supported it and they voted against it, not because they are genuinely frustrated at the number of illegal migrants entering our country, as those on this side of the House and the British public are, but because they will always stand up for unlimited migration and free movement. They have always said that and always will do. That is why they have voted against the new plan to tackle  crossings, with the right hon. Member for Torfaen (Nick Thomas-Symonds) opposing the development of operational solutions to turn back the boats. He even refuses to say if his ambition is to reduce the number of illegal migrants coming here. Can he do so today?
Those on the Government Benches will continue to confront this difficult and complex issue, no matter how controversial or complex others may deem it to be. We will find legislative and operational solutions, and we will treat this with the same grit and determination with which we have treated all the other challenges our country has faced, including leaving the European Union and delivering a points-based immigration system. Let me restate, as I did in February and have done repeatedly, that this will take time. The only solution to this problem is wholesale reform of our asylum system, which the new plan delivers.

Nick Thomas-Symonds: Some 25,700 people have risked their lives in these most dangerous shipping lanes this year alone. As the Home Secretary knows, the Government have already spent more than £200 million of taxpayers’ money on deals with the French authorities that are not working. The situation is getting worse. Will the Government commit to transparency on how the money is spent?
On 9 August, I asked the Home Office to facilitate a visit for me to Calais so that I could scrutinise what the money was being spent on. I eventually had a response last month from the Under-Secretary of State for the Home Department, the hon. Member for Corby (Tom Pursglove), referring me to the Foreign Office. I still have no substantive response. What do Ministers have to hide? I am conscious that I am being challenged about our position on the Nationality and Borders Bill, so let me make it absolutely clear: a Bill that breaches the refugee convention, that reduces protections for victims of modern slavery and that will not help the situation in the channel is not worthy of the Opposition’s support.
The Home Secretary has repeatedly made pledges that the route across the channel will be made unviable, but, as usual with this Government, it is all empty rhetoric and broken promises. The Home Secretary has blamed everyone but herself, and now we know that the Minister for the Cabinet Office, the right hon. Member for North East Cambridgeshire (Steve Barclay) has been brought in to look at this. Can we have some clarity from the Government? Who is actually in charge of immigration policy? Is it the Home Secretary or the Cabinet Office? Is not the fact that another Cabinet Minister has had to be brought in evidence that the Home Secretary has lost control of this dangerous situation?

Priti Patel: Of course, this would be the time of the week where we hear complete and utter nonsense coming from the Opposition Benches—for a change, I should add. Let me start with a number of facts. The right hon. Member for Torfaen (Nick Thomas-Symonds) asks about the Cabinet Office’s involvement; that is because—to restate something I have said again and again—this is a whole-of-Government effort. There is no single solution to fixing a global migration crisis. He speaks about a visit to Calais; from my last record, the United Kingdom is not responsible for visits to Calais, but I will happily take him to some of our processing sites around the country.
However, let us be very clear. The right hon. Gentleman has stated yet again that his party will not support the new plan for immigration or the Nationality and Borders Bill, which is the long-term solution to breaking the model, to reforming the asylum system, to deterring illegal migration and to addressing the underlying pull factors of the UK’s asylum system. It will introduce a one-stop appeals process, which clearly he and his party are against; it will ensure that asylum claims can be heard offshore in a third country and it will ensure that those individuals who come to our country not as genuine asylum seekers, but as economic migrants, can claim asylum in first safe countries. That is on top of a raft of operational and diplomatic work that is taking place—not just in France, by the way, but in Belgium, the Netherlands, Germany, Austria, Greece and Italy. We still speak to our European counterparts, and it is important that the Labour party acknowledges that Interior Ministers collectively have recognised a global migration problem.
I have said from the outset that this problem will take time to fix and that there is no silver bullet. The only solution is wholesale reform of our asylum system. Labour has consistently voted against the plan to do that. Instead of making practical suggestions, the Opposition are totally divorced from reality. They do not have a viable plan. The right hon. Gentleman constantly says that I should deepen my co-operation with France, while also criticising the Government for giving money to France to patrol its beaches. He has suggested the problem is down to reduced aid—failing to note that France is not a recipient of UK aid.
All the while the Nationality and Borders Bill is in Committee in the Commons, yet the Labour party continues to defend the rights of foreign national offenders, including murderers, rapists and those involved in the drugs trade—criminals, Mr Speaker. Labour has objected to provisions designed to prevent late submissions of evidence used to block removals of the very people we are trying to remove from our country, as well as to the one-stop-shop appeals process; it has opposed measures to tighten up immigration bail and to stop illegal migrants absconding. I come back to my opening remarks: we have a long-term plan to address these issues, while the Labour party will do everything possible to stop that plan from coming together.

John Redwood: What is the Home Secretary’s message to someone thinking of undertaking one of these illegal journeys, at great cost, as to why they should not take that risk and why it will not work?

Priti Patel: This is why we are bringing in new legislation. These individuals are putting their lives at risk and putting their lives in the hands of people smugglers. I come back to the work we are doing with the National Crime Agency, which has the resources and is going after the gangs, resulting in 94 ongoing investigations, 46 arrests and convictions—the last conviction was made last week, of an Albanian people smuggler.

Stuart McDonald: Nobody wants to see people risking their lives in crossing the channel, but it is time  for the Government to swap sensationalist rhetoric and barbaric Bills for evidence-based policy. The fact is that a significant majority of these people are likely refugees—Home Office officials have previously acknowledged that and so should the Home Secretary. Regardless of whether they are or not, these people should be treated decently and fairly, not criminalised, offshored or warehoused. The Home Secretary’s Bill is picking on asylum seekers instead of people smugglers—it is desperate stuff. There is no silver bullet, but we need co-operation with our neighbours to tackle smugglers and a two-way transfer agreement that allows for families to be reunited here, as well as for removals, where appropriate and lawful. In other words, we need to fix the problems that Brexit has caused. The Brexiteers have made their bed and they should lie in it. The Government cannot legislate their way out of this. We know already that inadmissibility rules have made things worse, not better. We know that offshoring will cost a fortune, will not work, and will destroy lives and any credibility that the UK has left—[Interruption.]

Lindsay Hoyle: Order. Mr Gullis, you have been catching my eye far too often. If you don’t behave, I’ll have a word with your mother.

Stuart McDonald: I am grateful to you, Mr Speaker, as that gives me the chance to repeat that we know already that offshoring will cost a fortune, will not work, and will destroy lives and any credibility that the UK has left. So it is time for the Government to ditch the criminalisation and the other cloud cuckoo policies that the Home Secretary’s own civil servants are criticising, and start working with the United Nations High Commissioner for Refugees and the independent inspector of borders, with their real-world, evidence-based and lawful recommendations.

Priti Patel: I am going to restate that the Nationality and Borders Bill, which is going through Parliament, will make life harder for the criminal gangs behind these crossings—all Members should be supporting that. It means that people smugglers could face a  life behind bars, and the hon. Gentleman should  be supporting that. We will strengthen Border Force’s powers to stop and redirect vessels and to search shipping containers to ensure that migrants are not being smuggled. Importantly, this will break the deadly business models of these smugglers. In addition, we want to make sure that the UK is less attractive to illegal migrants. He claims that all the people coming to the UK are genuine asylum seekers, but they are not, and the evidence shows that. Even the authorities in France say that 70% of people crossing the channel and entering France, and northern France in particular, are single men and they are economic migrants.

Karen Bradley: I refer the House to my entry in the Register of Members’ Financial Interests. The people responsible for this situation are the people traffickers, who sell false hope to the vulnerable. The only way we can address this is by working with our partners, allies and friends. Will  my right hon. Friend join the campaign to ensure  that this item is No. 1 at the next United Nations General Assembly?

Priti Patel: My right hon. Friend is absolutely right, and I am grateful to her because she has made one of the most intelligent contributions on this whole issue about people smugglers and working with counterparts in the world. I appreciate that Opposition Members completely reject relationship-building and speaking on a multilateral level, including with the United States; I noticed in particular the hon. Member for Bermondsey and Old Southwark (Neil Coyle) heckling earlier on. This is a very important point, because people smuggling and modern-day slavery is an international trade, and the Government have a proud history of and record on legislating, standing up and speaking out against it.

Yvette Cooper: The Home Secretary will understand that heightened rhetoric is not a substitute for practical, sensible measures that help in reality.
May I ask the right hon. Lady specifically about intelligence and joint surveillance work? Will she confirm that we were told in the Home Affairs Committee last week that drones, including UK funded drones, are not currently operating along the French coast as a result of a court case in France back in July, which we are hoping will be resolved by legislation in France over the next few months? We need France’s co-operation to do that. Will she further confirm that even UK drones in UK airspace are not operating more than five days a week? Why is that? Obviously, the criminal gangs do not stop at weekends.

Priti Patel: On France’s legislation, I have had discussions with my counterpart on that issue in the last week. Legislation is passing through the French Parliament because France has different surveillance laws. We have always been clear about that.
The right hon. Lady asked about technology. I have made a range of propositions to the French Interior Minister about surveillance and technology and the use of various other types of technology equipment—sensors on the beach and ANPR in particular. From my conversation and bilateral discussions with the Interior Minister last Monday, I tell the House now that he has accepted the use of all those.

Peter Bone: Would the excellent Home Secretary agree that the sensible and humane way to deal with this problem is for the French to agree a returns policy? In that way, we could give immigrants turning up on our shore a hot cup of tea and ensure that they had warm clothing, and they could be put back on the first ferry to Calais. That would make the cross-channel route unviable. It would be good for France, it would be good for the United Kingdom, and it would be devastating for the criminal people trafficking gangs.

Priti Patel: My hon. Friend has made a very important point about returns agreements, in particular with France. France assumes the presidency of the European Council next month, and this is an ongoing discussion that we are having with them. I am actively pursuing the issue, but I want to be very clear and realistic: it is only one aspect of the wider situation of dealing with illegal migration.
People are not just coming from France; they are coming from the Sahel, from Africa and from Libya through the Mediterranean route—this is a much wider issue than France. But obviously, returns agreements are crucial, absolutely pivotal, and they are one part of our wider plan.

Imran Hussain: The increasing anti-refugee, anti-migration rhetoric of the Home Secretary has left many of my hard-working constituents extremely fearful for their futures, particularly given the continued hostile environment created by the Home Office and her last-minute amendment to the Nationality and Borders Bill that would allow the Home Office to strip ordinary British nationals of their citizenship without warning. Stripping citizenship from ordinary people robs them of one of their most fundamental human rights and defies international law. When will the Home Secretary stop this hostile environment? When will she stop persecuting my law abiding constituents?

Priti Patel: I will be very happy to drop the hon. Gentleman a line with the full facts about the amendment, rather than responding to the rhetoric that he has just given.

Julian Lewis: Like the Home Secretary and many other Members of this House, I am the descendant of immigrants who came to this country legally. I am campaigning for more immigrants to be brought here legally who are at risk in Afghanistan.
What I cannot understand is how people who come here illegally—particularly those who, having done that, commit very serious crimes—cannot then be deported because they apparently have absolute rights conferred by various conventions. Most rights are capable of being overridden in extreme circumstances. If we are signed up to such conventions, is it not about time we reviewed them?

Priti Patel: My right hon. Friend makes some important points. First, as a country we always stand by our international obligations when it comes to people who are fleeing persecution and in need of refuge. That is what the Nationality and Borders Bill does and why we are creating safe and legal routes. My right hon. Friend will be familiar with much of our work that has taken place thus far with, for example, British nationals overseas—people from Hong Kong—and the work that is taking place on Afghanistan.
The removal of people with no legal right to be in the United Kingdom and all rights exhausted is at the heart of the new plan for immigration and the Nationality and Borders Bill, because too many last-minute claims come through immigration courts and tribunals and prevent the Government from removing people who have no legal right to be here. They include foreign national offenders, including rapists and murderers—people who have committed awful and abhorrent crimes on the streets of the United Kingdom. I have to say it is quite telling that there is a great deal of lobbying from the Labour party to actually stand by many of these foreign national offenders and keep them in our country.

Liz Saville-Roberts: Plaid Cymru rejects the cynical framing of this issue as a crisis of numbers; the true crisis is a lack of humanity from a succession of Westminster Governments who  scapegoat legitimate asylum seekers and refugees. In Wales, we take a different approach, with our stated ambition to be a nation of sanctuary for all people who seek support and flee persecution. Sadly, asylum remains a reserved matter. What consideration has the Home Secretary given to the lack of compatibility of her approach to channel crossings with that of Wales, with our nation of sanctuary and asylum seekers plan?

Priti Patel: It is important to restate, for the right hon. Lady’s benefit and that of all colleagues, that, as she will know, through the new plan for immigration and the work we are doing with the Nationality and Borders Bill, we are crystal clear about giving refuge to people who are fleeing persecution through safe and legal routes. That is in line with the refugee convention. I spend a great deal of time speaking to the UNHCR, the International Organisation for Migration and other international agencies that will work with us on this issue. I have to say that the right hon. Lady offered a slight mischaracterisation of the Nationality and Borders Bill.

Craig Mackinlay: I congratulate my right hon. Friend on the robustness of her language and her clear desire to stop irregular crossings. Poland has very much welcomed international assistance; I recommend that she makes a broad and generous offer to her French counterparts and asks how many British police, Border Force staff and, perhaps, troops we can put on site—on the beaches in France—to assist in their efforts and arrest more evil people smugglers.

Priti Patel: Let me put my hon. Friend’s mind at ease and at peace: I have done exactly that.

Diane Abbott: The Home Secretary spoke earlier about the importance of viable plans; does she still consider the use of wave machines in the channel to turn back small boats to be a viable plan? Does she still consider the sending of desperate asylum seekers to a third country, such as Albania, to be a viable plan? When will she stop using desperate asylum seekers as pawns in this Government’s culture wars?

Priti Patel: I categorically reject that notion and the right hon. Lady’s points. She mentioned wave machines; I have never ever suggested or recommended them. I say that for clarity and on the record for the House. As for the other matters, the right hon. Lady has heard me say this afternoon—I refer her to my earlier comments—that her party objects to changing our asylum system, fixing a broken system and, actually, improving the processing of asylum claims, which would, by the way, be of benefit to the individuals who have come to our country illegally. We want to make sure that we have a differentiated approach so that those people who are in genuine need get the support they need and those who have no legal grounds to be here are removed.

Desmond Swayne: Is there a danger that we raise expectations with the Nationality and Borders Bill unless there is an iron will on the part of Ministers to use the powers once they get them? And can my right hon. Friend not just tell the right hon. Member for Torfaen (Nick Thomas-Symonds) to make his own way to Calais?

Priti Patel: I say to my right hon. Friend that there is no lack of iron and no lack of will when it comes to the resolution and determination of myself, the Home Office and Ministers across the whole of Government to deliver the Nationality and Borders Bill.

Hilary Benn: The Home Affairs Committee was told recently that the total number of asylum seekers returned so far this year to the European Union was five and of course the Dublin regulation, which did permit the return of asylum seekers in certain circumstances to other EU member states, is no longer available to the Government. Could the Home Secretary tell the House how negotiations are going on trying to replace the Dublin regulation?

Priti Patel: I thank the right hon. Gentleman for his question because it is important to recognise that Dublin was not effective and did not work, and the people who have been removed to other EU countries were removed because they were inadmissible to the asylum system, in the light of the changes in the statutory instruments that I brought in earlier this year.

Henry Smith: The Nationality and Borders Bill will indeed be a significant piece of legislation to prevent illegal English channel migration crossings from taking place and it is shameful that the Labour party is voting against it. But it will be many months before that legislation is on the statute books, so what measures can be taken now, particularly in terms of security screening those who are attempting to enter the United Kingdom?

Priti Patel: Let me reassure my hon. Friend that screening takes place, as does interviewing and questioning of everyone who enters our country illegally. So let me be very clear about that. Any notion that that that is not taking place is completely wrong. He is right about the Bill. It is passing through the Commons right now, but, believe you me, Mr Speaker, we will do everything possible to look at how we can accelerate the passing of that legislation if we need to, particularly as the Labour party has made its opposition to it so publicly known.

Tim Farron: A few moments ago, the Home Secretary said that she wanted to welcome people who were genuinely fleeing persecution, but how can she know unless we go through due process with people who apply and claim asylum in this country? I am certain that she will also know that, per capita, the United Kingdom takes fewer asylum seekers each year than 23 members of the European Union. She will also know that we are not seeing a rise in the number of people seeking asylum in this country. We are seeing a greater number of people coming via the most dangerous routes. She will also know that, in order to stop people from taking utterly dangerous routes that we do not want them to take, she will need to provide safe routes because, without doing so, she plays into the hands of the people smugglers and she damages those people she says she wants to support.

Priti Patel: I know that this is a statement of the obvious, but many EU countries, including France, are safe countries, which is why not only the British Government, but other Governments around the world, including across the EU, pursue the principle of first  safe country. I am sure that, if the hon. Gentleman engaged with other colleagues across EU member states, they would all recognise the extent of illegal migration and the impact that that is having on their own countries as well. With regard to safe and legal routes, we are very clear—we have stated this in Committee and I have stated it many times—that we are working with UNHCR and the IOM because it is through that partnership, at a multilateral level, that we will form these safe and legal routes. They will be crucial partners to identify the very people—as we saw with the Syrian resettlement scheme—who are fleeing persecution and need refuge.

Paul Maynard: The Home Secretary should be aware of the very great anger of my constituents at the scenes that they see in the channel today and at the fact that these migrants are being inappropriately accommodated in a central Blackpool hotel. We hear much about France, but we know that these migrants are being held in both Belgium and Germany in a holding pattern only to be taken to France in the final 24 hours when the weather is conducive to a crossing. What steps is she taking to negotiate with both the Belgian and the German Governments to have a more combative approach to disrupting this pattern of delivering them to France?

Priti Patel: My hon. Friend has raised some important points. He asked about the discussions taking place with France, Belgium and Germany. There are plenty of discussions. In the past two weeks, I have had discussions with all three of those countries in terms of the work that needs to happen. I should also emphasise for the benefit of the House that it is the EU Commission that leads on illegal migration and that member states themselves are not supposed to engage on a bilateral level, and they are all breaking out of that cycle right now because of their own frustration with the Commission’s inability to grip this issue.
My hon. Friend asked about the issue of accommodation, about which his constituents are absolutely right to be angry. As I said in Home Office questions, we want to end the use of hotels. As part of the new plan for immigration, the Home Office and others across Government are looking to deliver reception centres.
Finally, my hon. Friend mentioned holding groups in Germany, Belgium and France. France, in particular, is clearing the camps. It is literally seeing the type of patterns that it has seen over the last decade, with migrant camps now reforming. Those camps are being cleared on a regular basis, and one of the largest camps was cleared last week.

Margaret Greenwood: One of my constituents, who has worked for maritime search and rescue, and has been saving lives at sea for more than a decade, is extremely concerned about the inherent risks of pushbacks at sea, as they can be highly dangerous manoeuvres and lead to loss of life. He is concerned, as am I, that the Government are proposing pushbacks in one of the busiest shipping lanes in the world, so on his behalf I ask the Home Secretary: what legal advice have   the Government taken on pushbacks; and if a migrant were to die during a pushback, who would be legally accountable for the death?

Priti Patel: It is important to say that all operational work—with Border Force and the maritime tactics team—is based on Government legal advice. Extensive legal advice has been taken on the issue. Specific training has taken place on operationalising tactics, alongside all the investment and the resources that have been put in place. The hon. Lady will be well aware, through her constituent, that there is an operational gold command that has responsibility for exercising the operations, and all the authorisations and powers within the legal framework to deliver those tactics.

Lee Anderson: Now then, seeing thousands and thousands of illegal immigrants coming across the channel is not the points-based immigration system that I thought we were going to adopt when we got to this place, so will my right hon. Friend please confirm that the best way to control illegal immigration is through offshore processing, and getting the Labour party over there to grow a backbone and back the borders Bill?

Priti Patel: It is self-evident. I do not want to enter the confused politics of the Labour party when it comes to migration, ending free movement and all of that, because Labour has resolutely voted against everything that we have done on immigration since the general election. The Nationality and Borders Bill is an end-to-end approach. There is no silver bullet. If there was, clearly we would not be seeing thousands of migrants entering our country illegally; not only that—solutions would have been found by now. Wholescale reform is vital, which is why we have the Bill. I am the first Home Secretary in 20 years to look at end-to-end reform of the system. I have worked on that reform for 18 months and introduced it in February this year. I urge all colleagues, certainly on the Government Benches, to back the Bill and focus on its delivery.

Kevan Jones: In response to my right hon. Friend the Member for Leeds Central (Hilary Benn), the Home Secretary was clearly not a fan of the Dublin regulation, so will she explain what negotiations are taking place to replace it? Will she also explain what we would do with individuals if we moved them to Albania or any other third country, and they failed the asylum system?

Priti Patel: First, I apologise to the right hon. Member for Leeds Central (Hilary Benn), because he did ask specifically about negotiations. There are a range of negotiations taking place, but he specifically asked about Dublin in relation to the EU. As he has heard me say already, that is an EU competency issue right now. We are having active discussions—this would not keep the Commission happy—with France, Belgium, the Netherlands, Austria, Germany, Italy, Greece, as of today Poland, and other countries. This is really important. They are having discussions with us because of their own frustration with the lack of progress in tackling wider long-term and long-scale issues around illegal migration, as well as returns and readmissions. All Governments are very much concentrating on these topics right now.
The right hon. Member for North Durham (Mr Jones) asked about third country offshoring. We will look at all options right now; it is right and proper that we do so. Not only that—we will look at resettlement routes for people who have entered our country legally and have no legal rights to be here. If they cannot be returned to their own country, it is right that we look at how we can resettle them elsewhere in the long term.

Alun Cairns: The Nationality and Borders Bill will make a significant difference in helping to address the challenges that we are facing, but does the Home Secretary agree that it is wholly unacceptable for the French authorities to turn a blind eye to small boats crossing, and does she accept that in doing so they are placing some of the most vulnerable people at risk?

Priti Patel: My right hon. Friend is right to raise the issue of vulnerability and our work with France. Just last week, I had dialogue and discussions bilaterally with my French counterpart, the French Interior Minister. There is wholesale recognition in the French system and across the French Government that a widescale crisis is taking place. The numbers that they are seeing in northern France are unprecedented. I know that the Labour party thinks that this is moving responsibility elsewhere, but we have to recognise that the root cause is the upstream routes where people are coming from and the fact that Schengen open borders mean that there are no border controls across the EU member states. A lot of work is taking place with our Government. We are being very strong activists and leaning into border protections not just domestically through our own legislative policies, but in some of the EU countries that have not been doing enough themselves.

Anum Qaisar: Facts matter, not sensational, xenophobic rhetoric peddled by this Government. Last month, the Home Secretary made the inaccurate claim that 70% of people who arrive in the UK by small boats are effectively economic migrants—[Interruption.] Well, no, because research from the Refugee Council this month confirms that that statement is inaccurate and instead shows that two thirds of people arriving here on small boats are deemed to be genuine refugees. Will she therefore withdraw her remarks?

Priti Patel: In the interests of accuracy, 70% of people crossing are single men and they are economic migrants.

Suzanne Webb: Does my right hon. Friend agree that it is the UK Government who are addressing the challenge of illegal immigration for the first time in decades, tackling the people smugglers, tackling illegal arrivals and removing those who should not be in our country, with a Bill that will protect those in genuine and immediate need, and that Opposition Members have perversely and repeatedly voted against?

Priti Patel: My hon. Friend has hit the nail on the head, because at the heart of the Bill is the simple principle that our immigration system should protect those in genuine need—people fleeing persecution and those in immediate need—and not act as a magnet for those living in safe places such as France and Belgium.

Mick Whitley: Putting your life and the lives of your loved ones on the line, in the hands of people smugglers, is an act of total and utter desperation—a last resort for many people fleeing war and persecution when no alternative is available to them. Does the Home Secretary agree that expanding the range of safe and legal routes into the UK is essential if we are to address the situation unfolding in the English channel?

Priti Patel: I refer the hon. Gentleman to my earlier comments. Safe and legal routes cannot be delivered on their own. We will be working with international partners such as the UNHCR and the IOM, in the same way that we have done with the Syrian resettlement scheme, to ensure that we support those who are fleeing persecution. I hope that is a policy that he will support.

Scott Benton: The Human Rights Act 1998 has handed power to unelected judges and it is clear that the creeping power of the courts is directly interfering in our ability to get a grip of our asylum and immigration policies. Does my right hon. Friend agree that, if we are finally going to stop bogus asylum seekers routinely coming to the UK, it is time to scrap the Human Rights Act altogether?

Priti Patel: My hon. Friend makes an important point about asylum claims, courts and tribunals, the prevarication, the delays and the frustration. That is why we have the Nationality and Borders Bill. That is why we will introduce, as part of one of the measures, a one-stop appeals process because, as we know, claimants go back again and again, care of UK taxpayers. We want to break that cycle; we want to stop that. We will, through that Bill, reform immigration courts and tribunals to deal with cases in a much more effective way.

Diana R. Johnson: Can I just gently remind the Home Secretary that it is her party that has been in power since 2010? Is it therefore a matter of incompetence on behalf of her Government that only five people have been removed in the past 12 months?

Priti Patel: The answer to that is no. Actually, it is a fact that we are developing returns agreements, including with India and Albania, and last week we were in discussions with Pakistan. Those are some of the countries that top the list in terms of failed asylum seekers and foreign national offenders. We are removing these people. The five people she refers to were removed because of a statutory instrument that the Opposition clearly did not support, which relates to inadmissibility with the type of claims that come at sea. That has come through diligent work not only with our colleagues in the Home Office, but with our counterparts across EU member states.

Duncan Baker: The Nationality and Borders Bill contains many similarities to what was used successfully by the Australians in its Operation Sovereign Borders policy in 2013. Can my right hon. Friend dismiss the comments in The Times last week that said:
“Ministers have not given details of how the offshore centres will work. But Britain cannot detain the migrants at the centres…as that would breach international law”?
As a sovereign country in control of our law making, nothing could be further from the truth.

Priti Patel: Our Parliament is sovereign, and that is why we will work assiduously to ensure that the Nationality and Borders Bill gets through and gets Royal Assent. Then we can absolutely deliver for the British people.

Clive Efford: The figures this year have tripled to 25,000 people making crossings. On the current trajectory, that is projected to increase to 78,000 next year. Last week, the Home Secretary said that she had come to an agreement with French authorities to say that there would be a 100% reduction in crossings, yet the French authorities said they knew nothing about it. When she says that she is having negotiations that will effectively reduce the number of crossings, who exactly has she been talking to?

Priti Patel: First, I have been directly engaging with the French Government and the French Interior Minister. In regard to that comment about stopping crossings 100%, those were not my words but those of the French Interior Minister.

Mike Wood: International people smugglers know that they only need to get the boats into British waters before their clients can claim asylum in the UK. Does the Home Secretary agree that we must therefore change legislation to allow for the option of offshore processing and return? What message does she think it sends when the Labour party calls for action in this place, but then whips its Members to vote against every part of the Bill that would make it happen?

Priti Patel: My hon. Friend has seen the Labour party in action in the Bill Committee, where it is opposing the solutions that this Government are putting forward and our strong legislation to break the people smuggling gangs and ensure that we can find safe and legal routes for people fleeing persecution. It is also important to add on this point that when it comes to processing asylum claims, we must have a differentiated approach. Through this Bill, we want to end some of the pull factors for the economic migrants who have been masquerading as asylum seekers and elbowing to one side women and children—the very people to whom we should be giving asylum.

Khalid Mahmood: I agree with my right hon. Friend the shadow Home Secretary when he says that the people coming across looking for refugee status or asylum status here will have their human rights downgraded if the Bill that the Home Secretary is pushing forward goes ahead. These are people whose human rights have already been abused in their place of origin. The Home Secretary has spoken in response to earlier questions about looking at safe routes. When those people obtain safe routes through the national agencies, will she allow them to settle here?

Priti Patel: The point about safe and legal routes is that they become the pathway to resettlement. The hon. Gentleman will be familiar with the Syrian resettlement  regime, which a predecessor of mine and former Prime Minister, my right hon. Friend the Member for Maidenhead (Mrs May), led when she was Home Secretary. It worked with the multilateral system and third-party agencies, which is the right and proper thing to do. They have the expertise in identifying people. Once they have identified people and we have identified the right resettlement pathways and where those people can resettle in the United Kingdom, we can then bring them to the UK. That is the right approach, because we have to look at how asylum seekers are being housed, and the pressures on housing and on local authorities, which we debated about an hour and a half ago, have to be taken into consideration. The resettlement routes must deliver for the individuals fleeing persecution, while showing that the United Kingdom and its Government are generous and welcoming and that resettlement does what it says on the tin.

Stephen Metcalfe: People across the country are rightly angry about the current situation and want action, so I welcome the steps that my right hon. Friend is taking and the legislation that is being brought forward. If we need new specific powers, she should bring them forward now to the House so that we can act with the speed that our constituents want, as we did with covid.

Priti Patel: The Nationality and Borders Bill is going through the House right now. As I have always said, we look at all options, and those options are in the Bill. Obviously, if other legislative measures are required, the Government will look at them and bring them forward.

Kim Johnson: Does the Home Secretary agree that the narrative on immigration needs to change? As we have heard, 70% of asylum seekers are fleeing from persecution, greater numbers have been risking their lives to cross the channel in flimsy boats, and there has been net negative immigration with more people leaving the country than arriving. Does she agree that proportionately, the UK supports lower numbers than Germany, Spain, Greece and France?

Priti Patel: In the interests of time, I refer the hon. Lady to the new plan for immigration. On page 6, she will see that:
“The UK accepted more refugees through planned resettlement schemes than any other country in Europe in the period 2015-2019”.
That answers her question about the number of people who are coming here.

Jack Brereton: We have seen thousands of people coming into the country. Many areas, such as Stoke-on-Trent, which has already taken far more than its fair share, are continuing to see increased pressure. Will my right hon. Friend look at measures to reduce the numbers coming into the country and ensure that there is a much fairer share across the country?

Priti Patel: I thank my hon. Friend and all hon. Members from Stoke-on-Trent in particular who have been very clear and engaged with me and the Department on the whole issue of asylum accommodation. They have demonstrated, with their local council leader, who has been outstanding, the principles of fairness and value in how we engage with local authorities.
My hon. Friend knows my message on this issue: we need other local authorities across the United Kingdom to step up, we really do. I restate that the long-term plan—it will not happen overnight—is to move people out of the current accommodation that they are in. They are in that accommodation for various reasons linked to the pandemic and Public Health England guidance. The Government, across Government and with military support, will be building reception centres.

Joanna Cherry: At the beginning, the Home Secretary said that she would like to hear some concrete alternative proposals from the Opposition, so I will give her one. In written evidence to the Joint Committee on Human Rights, Donate4Refugees suggested that the most effective way to deter channel crossings would be to:
“Allow people to claim asylum at our frontier controls in France”
and complete the initial stage of their application there. If it was accepted, the Home Office could
“transfer them to the UK on regular transport”
to commence
“the ‘normal’ UK process of dispersal accommodation and asylum support”.
Has she given any consideration to that idea?

Priti Patel: It is fair to say that that proposal of using juxtaposed controls to effectively process asylum seekers is not something that the British Government or the French Government would entertain. That is why we have wide-scale end-to-end reform in the new plan for immigration.

Marco Longhi: Does my right hon. Friend agree that unlike Opposition Members who would have completely open borders, Government Members will, with determination, sort out the problem of illegal immigration? Given that there are so many persecuted people in Calais, does she agree that perhaps we should ask the United Nations to investigate what is happening in that country?

Priti Patel: That is a telling comment. Of course, it would not be the United Nations in France; it is actually the role of the European Commission. Speaking to my counterparts across EU member states, they are somewhat exasperated right now about the lack of leadership on the issue, which is why member states are engaging with us directly. We are looking at a whole-of-route approach. I should say that we are also working with the National Crime Agency and with other countries upstream to look at how we can find some long-term solutions.

Debbie Abrahams: I think we should all remember why we have the 1951 UN refugee convention. It was established after the second world war as a result of millions of Jewish people being unable to seek refuge legally outside Germany and perishing as a consequence. The UNHCR, in spite of what the Home Secretary has said, has stated that it believes the Nationality and Borders Bill
“undermines established international refugee protection rules and practices.”
I am quoting from its website. I would like to ask the Home Secretary: what proportion of those crossing the channel do so because they have existing family members here?

Priti Patel: As I have already stated, and the French authorities say this too, the majority—70%—are economic migrants. They are single men coming to the United Kingdom, and many of them—

Debbie Abrahams: What proportion—

Priti Patel: If the hon. Lady would like to listen, rather than talk over me—[Interruption.] If the hon. Lady would like to listen, many of them are also trying to deceive local authorities about their own ages, claiming that they are children, and the new plan for immigration will fundamentally address that.

Debbie Abrahams: indicated dissent.

Priti Patel: The hon. Lady can shake her head, and I know that the Opposition have voted against age verification. On the point about the UNHCR—[Interruption.] If she would like to listen, rather than just yelling back, on the point about the UNHCR, safe and legal routes and resettlement routes are absolutely in line with the international convention on refuge. We are working with it, and we are having discussions with it. Only two weeks ago, I met the International Committee of the Red Cross, and I have been touch with UNHCR about these issues, because it is important not only that we stand by the convention—

Debbie Abrahams: indicated dissent.

Priti Patel: The hon. Lady can shake her head, but it is also important that we deliver safe and legal routes in a fair way, so that those individuals who are fleeing persecution are given the support they seek.

Tom Hunt: Does the Home Secretary share my surprise that the Opposition have decided to bring this urgent question forward, because of course not only have they voted against the Nationality and Borders Bill, but they are also voting against the Judicial Review and Courts Bill, which in ending Cart judicial review will make it far easier to deport illegal immigrants?

Priti Patel: Well, I do not think I have much to add. My hon. Friend has absolutely made the case for voting for that Bill and for the reforms that we are bringing in, and the Labour party is behaving like a computer that says no all the time.

Paul Blomfield: The Home Secretary has this afternoon put the Nationality and Borders Bill at the very centre of her plans, but her Department’s own impact assessment cautioned that
“evidence supporting the effectiveness of this approach is limited”,
and it went on to say that some of its measures
“could encourage these cohorts to attempt riskier means of entering the UK.”
Will she not accept the evidence of her own Department, and abandon plans that seem more designed to provide headlines than a solution?

Priti Patel: Absolutely wrong. That is the wrong characterisation, quite frankly, of the Nationality and Borders Bill and of the new plan for immigration, which has a range of measures, including a one-stop appeal process, the ability for claims to be processed in a different way and heard offshore, and, importantly, the ability to ensure that individuals who are fleeing persecution are given the help and the support they need. I find it absolutely extraordinary that Member after Member on the Opposition Benches stands up and just says, on the one hand, “You’re not doing enough as a Government to stop illegal migration,” while on the other hand in effect saying, “What you are doing is not good enough, and we are voting against it.” I have made it quite clear from the onset not only that this problem will take time to fix—

Paul Blomfield: Your Department said—[Interruption.]

Priti Patel: If the hon. Member would like to listen to my response, rather than yelling at me—he is not even speaking in a low voice, just yelling at me—there is no silver bullet, and the only solution is whole-scale reform. That whole-scale reform has to address pull factors, it has to ensure that we have safe and legal routes, it has to have a differentiated approach, it has to make sure that we can house people in the right kind of way and it has to ensure that we have the infrastructure in the United Kingdom to support people on resettlement pathways. Currently, our plan and the Bill will deliver that, whereas under the current broken system, which has not been reformed for 20 years, we are not able to deliver our asylum system in a fair way. The various pulls are actually bringing people to the country illegally, and we do need to stop that.

Tom Randall: Given that so many Labour Members would prefer us to be in ever closer political union with countries such as France, Belgium and Germany, does my right hon. Friend share my surprise that they do not consider those countries to be mature democracies with functioning asylum systems for the purposes of this exercise? Does she agree that people should claim asylum in the first safe country, rather than take dangerous routes across the channel?

Priti Patel: My hon. Friend is absolutely right, and there must be some honestly about what is happening with asylum seekers transiting through EU member states and coming to the United Kingdom. The whole of the EU is safe, and all those countries, including France, Belgium, the Netherlands, and other countries that are well known and have been referenced, have functioning asylum systems. We must break the pattern of asylum shopping, which is being provided by criminal gangs and people smugglers, and that is effectively what the Bill will do.

Fleur Anderson: May I give the Home Secretary another opportunity to put the record straight? Last month, before the Justice and Home Affairs Committee, she claimed that 70% of those travelling to the UK across the channel were “not genuine asylum seekers.” However, analysis by Refugee Council, based on Home Office data, shows that two thirds of applicants have been granted asylum status and so are fleeing for  their lives, many with contacts and family in the UK. Does she dispute her own Department’s data on that? Which is it?

Priti Patel: First, I stand by the claim, as do my colleagues in Europe—the French Minister of the Interior and I speak about this frequently—that 70% of those coming across France’s borders and across the channel to the United Kingdom are single men. I am not going to restate that position any more, and I refer the hon. Lady to comments I have made previously. I appreciate that she may wish to quote the Refugee Council, but quite frankly there is a fundamental point here: the current system is broken, this Government are trying to reform and change it, and the Labour party is trying to block that reform.

David Simmonds: I commend my right hon. Friend on her recognition that the system, as it currently stands, does not reflect the humanitarian instinct of the British people. Regarding our ability to intervene against people smugglers in French territorial waters, what is her view of Frontex, the EU border and coastguard agency, which we might expect to play a similar role to that played by the UK Border Agency on this side of the English channel?

Priti Patel: That is a great question, and Frontex in particular has an important role to play. I have travelled across certain EU countries and seen Frontex in operation, but not in France, and not with our near neighbours and on our near borders. The Commission is under pressure right now as it has been asked by many member states to provide broader protection. That is out of our remit and a matter for the Commission, but it is vital that it steps up. The lack of border protection is having an ongoing, knock-on impact on people smugglers and on porous borders, and on people coming to the United Kingdom.

Chi Onwurah: The Home Secretary knows that the UK receives fewer asylum seekers—these are not people applying via the resettlement scheme—per head of population than the European average, yet after 11 years in power, she cannot process their applications in a timely manner, subjecting them to further physical and mental distress, or even control our borders, meaning that thousands are making that perilous crossing. Will she stop blaming the French, the European Union, the Royal National Lifeboat Institution, the weather, the migrants themselves, and take some responsibility? Fix the broken system, because the Nationality and Borders Bill certainly will not do that.

Priti Patel: On the hon. Lady’s ultimate point, the Nationality and Borders Bill is an important piece of legislation to fix the broken asylum system. This is not just about the Conservative party being in power; when the Labour party was in power it did nothing to fix the asylum system. We are tackling this issue. I appreciate that Labour Members will not support the Bill, but at the same time they are supporting a broken system, and end-to-end reform of it is required. Yes, I want to fix the system—[Interruption.] The hon. Lady can shake her head and talk above me, but that is what we are trying to do through the Bill.

Richard Holden: In 2019 my constituents rejected Labour’s open door immigration policy. Since then we have been getting  on with delivering our new Australian-style points- based immigration system in the teeth of opposition from the Labour party. Will the Home Secretary listen to my constituents in Consett, Crook and across North West Durham, rather than to the Labour party, and agree that we must now adopt an Australian approach to stopping the small boats in the channel? Offshore  processing, turning them back—whatever it takes  to secure our borders and stop the awful human  traffickers.

Priti Patel: My hon. Friend is absolutely right. He speaks with passion and conviction on this issue for a very good reason, which of course is that the British public are sick to death of this. They are absolutely, heartily sick of what they are seeing, and that speaks to many of the abuses that take place in our asylum system and the fact that the system is broken. Yes, processing takes too long, and yes, we have had the pandemic; there is a range of reasons why this is the case, but we want to address it and fix it and tackle it long term. There are no simple solutions, which is why the legislation is so important.

Neil Coyle: As it stands, the Nationality and Borders Bill will criminalise the work of the RNLI, as the Under-Secretary of State for the Home Department, the hon. Member for Corby (Tom Pursglove), acknowledged in Committee; it is an outrageous situation. I have tabled an amendment to prevent the RNLI from being prosecuted for its courageous humanitarian work. Will the Home Secretary meet RNLI staff and volunteers and adopt my amendment to protect these frontline life savers, who have sadly already been the target of abuse and attacks because of the Government’s irresponsible narrative and media headlines on this issue?

Priti Patel: We have been very clear that we will table an amendment on Report on the specific point that the hon. Gentleman has made. What I would also say about the Bill—[Interruption.]—if he lets me finish. Of course, the importance of the Bill is that it will not just bring about long-term reform but make life harder for the criminal gangs behind these crossings. That is something that should unite us all, and we absolutely want to make sure that happens.

Jonathan Gullis: Let me start with a quote:
“When a person leaves their country through fear, we consider that, as a general principle, such a person should seek protection in the first safe country where they have the chance to  do so.”—[Official Report, House of Lords, 5 April 2004; Vol. 459, c. 1684.]
I agree with that quote, and the people of Stoke-on-Trent North, Kidsgrove and Talke agree with that quote. It is a quote of the Labour Minister, Baroness Scotland, in 2004—when Labour used to win elections. Does my right hon. Friend agree with that quote, and will she tell that lot over there to vote for the Nationality and Borders Bill?

Priti Patel: My hon. Friend makes a very important point. No one can dispute the fact that those who are seeking to claim asylum should do so in the first safe country. That is a long-standing principle, and it is one that we stand by.

Wera Hobhouse: Clearly, this country was far more successful in dealing with illegal immigration as a member of the European Union than it is now, with five people removed compared with 263 before we left. In her answer to the right hon. Member for Leeds Central (Hilary Benn), the Home Secretary was not very clear about the successor agreement to the Dublin regulation, so will she clarify who would be responsible for negotiating any such agreement? Is it the EU Commission or individual member states?

Priti Patel: It is the EU Commission.

Brendan Clarke-Smith: My right hon. Friend may recall that the Leader of the Opposition once infamously said that all immigration controls are racist. Does she agree that all immigration controls are racist, or does she agree with me that that demonstrates not only that the Opposition cannot be trusted on small boats but that a Labour Government means open borders?

Priti Patel: I thank my hon. Friend. First, I think Labour Members have made their position clear, not just on legal migration but on illegal migration, with their resistance to everything we have done on a points-based system, ending free movement and, obviously, our plans now to reform a broken asylum system and tackle illegal migration. The Bill is an important piece of legislation. We want to make it harder for the criminal gangs behind these crossings; we want to make the UK less attractive and viable for illegal migration, which really is crucial; and importantly—this is something that the Labour party has not been supportive of either—we want to remove those individuals with no legal right to be here, and we will do that through our legislation.

Jonathan Edwards: In response to the British Government’s policy, the Albanian Government have said that Albania
“will never be a hub of anti-immigration policies of bigger and richer countries.”
Which other territories are the British Government considering for their immoral offshore migrant centres?

Priti Patel: I am not going to provide any commentary at all in terms of other countries that we are negotiating with. It is for the Government to go away and do this work, which we are doing, and not to start speculating and creating false expectations around much of this work.

Philip Hollobone: Crossing the English channel in an overcrowded flimsy boat has been described as the equivalent of a pedestrian trying to cross both carriageways of the M25 in rush hour. In terms of humanitarian safety alone, the Home Secretary asked for constructive suggestions. Surely it is not beyond the wit of man for us to have joint naval patrols with the French, so that if migrants are intercepted at sea they are landed not at Dover, but back in France?

Priti Patel: Without going into operational details, we discuss all options. We absolutely do discuss all options. Whether it is naval patrols or alternative patrols, we are constantly exploring and discussing options. It is not appropriate for me to comment on the responsibilities of other Government Departments, but work is taking place with our counterparts and other Departments in Government.

Jim Shannon: I thank the Secretary of State for her responses to very difficult questioning. Will she outline what discussions have taken place with her counterparts in France regarding the prevention of small boat crossings, which have trebled in the past year? Has she impressed on the French that their responsibility is not simply a diplomatic one, but a moral responsibility and a safety issue, and that their abdication of that responsibility can and will result in injury and death?

Priti Patel: Absolutely right. The answer is of course yes. Pressing the moral and humanitarian case, and breaking up the criminal networks, is exactly what this is all about. The gangs and networks have not flourished overnight. They are long-established, which is why we have to look at it from that perspective. I can assure the hon. Gentleman that I am doing that constantly.

Luke Evans: In answers to questions, the Home Secretary has talked a number of times about age verification and people trying to cheat the system by coming in as if they are children. How would age verification work? How many other countries use it as a tool, whether in Europe or elsewhere in the world, to ensure that those who come are genuinely who they say they are?

Priti Patel: This is an important question. My hon. Friend raises important points around the age verification of illegal migrants who pose as children. That poses   wider security and safeguarding concerns. We have seen in previous years, I am very disappointed to say, grown adult men in schools, which poses wider safeguarding issues. My hon. Friend asks about other countries and the type of techniques they use. The techniques we are proposing in the Nationality and Borders Bill are used in many EU member states.

Stephen Farry: I have to say that a lot of the language used today in relation to those fleeing war and persecution—dehumanising them and demonising them—is deeply, deeply troubling. There are about 80 million people around the world who are either refugees or internally displaced. The UK is being asked to help only a small fraction. Will the Home Secretary recognise that under the 1951 refugee convention, people do not have to seek asylum in the first safe country they reach?

Priti Patel: I disagree with the hon. Gentleman’s overall tone. This is a lively debate for a range of reasons, and there are very serious and important issues at stake. The Government are very clear on moral obligations, humanitarian commitments, standing by the refugee convention, international treaties, and working with the right multilateral agencies to provide help and support to those fleeing persecution. We stand by that. I have said many, many times over the course of the last couple of hours that that is work we are doing and will continue to do. There are 80 million people around the world who are displaced or fleeing their own countries for a wide range of reasons, but there is an important point to make. The United Kingdom cannot accommodate everyone, which is why the international community also needs to do much more in terms of safe and legal routes—we are working internationally on that—and why we are bringing in long-term reforms.

Nigel Evans: I thank the Home Secretary for responding to questions for almost an hour and 10 minutes.

Points of Order

Jeremy Hunt: On a point of order, Mr Deputy Speaker. I wonder if you could advise me on how I can put on record my dismay, and that of my right hon. Friend the Member for Tunbridge Wells (Greg Clark), at the leaking of private Select Committee discussions ahead of our recent joint report on coronavirus lessons learnt. The report was ultimately agreed unanimously by Members of three parties on two Committees. I want to put on record my view that the hon. Member for Luton North (Sarah Owen) does an outstanding job as a Select Committee member, and I know that my right hon. Friend the Member for Tunbridge Wells has the same view of the hon. Member for Brent Central (Dawn Butler).

Nigel Evans: I thank Mr Hunt for forward notice of his point of order. He asks how he can put it on the record—well, he has just done that, so congratulations on that. It is important that private discussions in Committees remain private. I am happy to join him in paying tribute to the hon. Members for Brent Central (Dawn Butler) and for Luton North (Sarah Owen), who I am absolutely certain work hard on behalf of their Select Committees. Anybody who sits on a Select Committee must know that it is a privilege to do so, and that there should be no leaking whatever.

Fleur Anderson: On a point of order, Mr Deputy Speaker. Twelve of my constituents have contacted me because they have been waiting for driving licences from the Driver and Vehicle Licensing Agency for months, and they cannot get through. They have  tried to call it, and there is no answer; I have tried to call it, and I cannot get through; I have contacted the MP hotline, and I am still waiting for a response. One constituent had a brain tumour and has been applying for his medical renewal licence since May. Please could you advise me on which parliamentary mechanisms are available to me? This is not good enough for my constituents.

Nigel Evans: I thank the hon. Lady for advance notice of her point of order. It is not for the Chair to comment on the DVLA, but I can say that I am aware from other Members of Parliament that responses are simply not coming forward from it. I am concerned to hear that right hon. and hon. Members are not receiving responses, especially if the service is described as a hotline. The hon. Lady’s point will have been heard by Members on the Government Benches; I hope that speedy action is taken. She might wish to discuss the matter with Clerks in the Table Office, who will be able to advise her on ways to pursue the matter.

Geraint Davies: Further to that point of order, Mr Deputy Speaker. With respect to the DVLA, you may be aware that a deal with the unions was on the table to ensure greater productivity and safety, but it was ripped off the table by the Secretary of State for Transport. Had it not been, we might be getting better responses to the public. May I, through you, Mr Deputy Speaker, urge the Government to get on with getting both sides together, so that we can get a proper service, rather than punishing the workers and putting them at risk?

Nigel Evans: That was a point of information rather than a point of order, but I am sure that it was heard by Members on the Treasury Bench.

Health and Care Bill  (Programme) (No.2)

Ordered,
That the Order of 14 July 2021 (Health and Care Bill (Programme)) be varied as follows:
(1) Paragraphs (4) and (5) of the Order shall be omitted.
(2) Proceedings on Consideration and Third Reading shall be taken in two days in accordance with the following provisions of this Order.
(3) Proceedings on Consideration—
(a) shall be taken on each of those days in the order shown in the first column of the following Table, and
(b) shall (so far as not previously concluded) be brought to a conclusion at the times specified in the second column of the Table.

  

  Proceedings
  Time for conclusion of proceedings


  New Clauses, new Schedules and amendments relating to tobacco or nicotine products, and new Clauses, new Schedules and amendments relating to food or drink or its impact on health
  7 pm on the first day


  New Clauses, new Schedules and amendments relating to integrated care boards, integrated care partnerships or integrated care systems, and new Clauses, new Schedules and amendments relating to the cap on care costs
  10 pm on the first day


  New Clauses, new Schedules and amendments relating to the workforce in the health service or related sectors, new Clauses, new Schedules and amendments relating to cosmetic procedures, virginity testing or hymenoplasty, and new Clauses, new Schedules and amendments relating to the Health Services Safety Investigations Body
  4.30 pm on the second day


  Remaining proceedings on Consideration
  6 pm on the second day

  

(4) Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at 7 pm on the second day.—(Edward Argar.)

Health and Care Bill

[Day 1]

Consideration of Bill, as amended in the Public Bill Committee
[Relevant documents: Oral evidence taken before the Treasury Committee on 18 November 2021, on Autumn Budget and Spending Review 2021, HC 825 [expected to be published on the Treasury Committee webpages by 1400 on Monday 22 November]; First Report of the Health and Social Care Committee, The Government’s White Paper proposals for the reform of Health and Social Care, HC 20.]

New Clause 2 - Health warnings on cigarettes and cigarette papers

“The Secretary of State may by regulations require tobacco manufacturers to print health warnings on individual cigarettes and cigarette rolling papers.”—(Mary Kelly Foy.)
This new clause would give powers to the Secretary of State to require manufacturers to print health warnings on individual cigarettes.
Brought up, and read the First time.

Mary Foy: I beg to move, That the clause be read a Second time.

Lindsay Hoyle: With this it will be convenient to discuss the following:
New clause 3—Cigarette pack inserts—
“The Secretary of State may by regulations require tobacco manufacturers to display a health information message on a leaflet inserted in cigarette packaging.”
This new clause would give powers to the Secretary of State to require manufacturers to insert leaflets containing health information and information about smoking cessation services inside cigarette packaging.
New clause 4—Packaging and labelling of nicotine products—
“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”
This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.
New clause 5—Sale and distribution of nicotine products to children under the age of 18 years—
“(1) The Secretary of State may by regulations prohibit the free distribution of nicotine products to those aged under 18 years, and prohibit the sale of all nicotine products to those under 18.
(2) Regulations under subsection (1) must include an exception for medicines or medical devices indicated for the treatment of persons aged under 18.”
This new clause would give powers to the Secretary of State to prohibit the free distribution or sale of any consumer nicotine product to anyone under 18, while allowing the sale or distribution of nicotine replacement therapy licensed for use by under 18s.
New clause 6—Flavoured tobacco products—
“The Secretary of State may by regulations remove the limitation of the prohibition of flavours in cigarettes or tobacco products to ‘characterising’ flavours, and extend the flavour  prohibition to all tobacco products as well as smoking accessories including filter papers, filters and other products designed to flavour tobacco products.”
This new clause would give powers to the Secretary of State to prohibit any flavouring in any tobacco product or smoking accessory.
New clause 8—Tobacco supplies: statutory schemes (supplementary)—
“(1) The Secretary of State may make any provision the Secretary of State considers necessary or expedient for the purpose of enabling or facilitating—
(a) the introduction of a statutory scheme under section [Tobacco supplies: Statutory schemes], or
(b) the determination of the provision to be made in a proposed statutory scheme.
(2) The provision may, in particular, require any person to whom such a scheme may apply to—
(a) record and keep information,
(b) provide information to the Secretary of State in electronic form.
(3) The Secretary of State must—
(a) store electronically the information which is submitted in accordance with subsection (2);
(b) ensure that information submitted in accordance with this provision is made publicly available on a website, taking the need to protect trade secrets duly into account.
(4) Where the Secretary of State is preparing to make or vary a statutory scheme, the Secretary of State may make any provision the Secretary of State considers necessary or expedient for transitional or transitory purposes which could be made by such a scheme.”
This new clause and NC7, NC9 and NC10 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.
New clause 9—Tobacco supplies: enforcement—
“(1) Regulations may provide for a person who contravenes any provision of regulations or directions under section [Tobacco supplies: statutory schemes] to be liable to pay a penalty to the Secretary of State.
(2) The penalty may be—
(a) a single penalty not exceeding £5 million,
(b) a daily penalty not exceeding £500,000 for every day on which the contravention occurs or continues.
(3) Regulations may provide for any amount required to be paid to the Secretary of State by virtue of section [Tobacco supplies: statutory schemes] (4) or (6)(b) to be increased by an amount not exceeding 50 per cent.
(4) Regulations may provide for any amount payable to the Secretary of State by virtue of provision made under section [Tobacco supplies: statutory schemes] (3), (4), (5) or (6)(b) (including such an amount as increased under subsection (3)) to carry interest at a rate specified or referred to in the regulations.
(5) Provision may be made by regulations for conferring on manufacturers and importers a right of appeal against enforcement decisions taken in respect of them in pursuance of [Tobacco supplies: statutory schemes], [Tobacco supplies: statutory schemes (supplementary)] and this section.
(6) The provision which may be made by virtue of subsection (5) includes any provision which may be made by model provisions with respect to appeals under section 6 of the Deregulation and Contracting Out Act 1994 (c. 40), reading—
(a) the references in subsections (4) and (5) of that section to enforcement action as references to action taken to implement an enforcement decision,
(b) in subsection (5) of that section, the references to interested persons as references to any persons and the reference to any decision to take enforcement action as a reference to any enforcement decision.
(7) In subsections (5) and (6), ‘enforcement decision’ means a decision of the Secretary of State or any other person to—
(a) require a specific manufacturer or importer to provide information to him,
(b) limit, in respect of any specific manufacturer or importer, any price or profit,
(c) refuse to give approval to a price increase made by a specific manufacturer or importer,
(d) require a specific manufacturer or importer to pay any amount (including an amount by way of penalty) to the Secretary of State,
and in this subsection ‘specific’ means specified in the decision.
(8) A requirement or prohibition, or a limit, under section [Tobacco supplies: statutory schemes], may only be enforced under this section and may not be relied on in any proceedings other than proceedings under this section.
(9) Subsection (8) does not apply to any action by the Secretary of State to recover as a debt any amount required to be paid to the Secretary of State under section [Tobacco supplies: statutory schemes] or this section.
(10) The Secretary of State may by order increase (or further increase) either of the sums mentioned in subsection (2).”
This new clause and NC7, NC8 and NC10 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.
New clause 10—Tobacco supplies: controls: (supplementary)—
“(1) Any power conferred on the Secretary of State by section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] may be exercised by—
(a) making regulations, or
(b) giving directions to a specific manufacturer or importer.
(2) Regulations under subsection (1)(a) may confer power for the Secretary of State to give directions to a specific manufacturer or importer; and in this subsection ‘specific’ means specified in the direction concerned.
(3) In this section and section [Tobacco supplies: statutory schemes] and [Tobacco supplies: statutory schemes (supplementary)] and [Tobacco supplies: enforcement]—
‘tobacco product’ means a product that can be consumed and consists, even partly, of tobacco;
‘manufacturer’ means any person who manufactures tobacco products;
‘importer’ means any person who imports tobacco products into the UK with a view to the product being supplied for consumption in the United Kingdom or through the travel retail sector, and contravention of a provision includes a failure to comply with it.”
This new clause and NC7, NC8 and NC9 would enable the Secretary of State for Health and Social Care to regulate prices and profits of tobacco manufacturers and importers.
New clause 11—Age of sale of tobacco—
“The Secretary of State must consult on raising the age of sale for tobacco from 18 to 21 within three months of the passage of this Act.”
This new clause would require the Secretary of State to consult on raising the age of sale for tobacco products to 21.
New clause 14—Implementation of Restrictions on advertising of less healthy food and drink online—
“The regulator shall put in place a mechanism for the delivery of the requirements under Part 2 of Schedule 16 which shall require that advertisers—
(a) apply media targeting filters, based on robust audience measurement data, to ensure the avoidance of children’s media or editorial content of particular appeal to children;
(b) use audience targeting tools and, where available, proprietary audience or other first-party data to further exclude children; and
(c) use campaign evaluation tools to assess audience impacts and use any learning to continually improve future targeting approaches.”
This new clause would require the regulator to put in place a three-step “filtering” process for restricting online advertising by managing the targeting of an online advertising campaign for foods that are high in fat, salt or sugar, as developed by the Committee of Advertising Practice of the Advertising Standards Authority.
New clause 15—Alcohol product labelling—
“The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or in future versions of that guidance, display—
(a) the Chief Medical Officers’ low risk drinking guidelines,
(b) a warning that is intended to inform the public of the danger of alcohol consumption,
(c) a warning that is intended to inform the public of the danger of alcohol consumption when pregnant,
(d) a warning that is intended to inform the public of the direct link between alcohol and cancer, and
(e) a full list of ingredients and nutritional information.”
This new clause requires the Secretary of State to introduce secondary legislation on alcohol product labelling.
New clause 16—Annual report on alcohol treatment services: assessment of outcomes—
“(1) The Secretary of State must lay before each House of Parliament at the start of each financial year a report on—
(a) the ways in which alcohol treatment providers have been supported in tackling excess mortality, alcohol related hospital admissions, and the burden of disease resulting from alcohol consumption, and
(b) the number of people identified as requiring support who are receiving treatment.
(2) Alongside the publication of the report, the Secretary of State must publish an assessment of the impact of the level of funding for alcohol treatment providers on their ability to deliver a high-quality service that enables patient choice.”
This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by alcohol treatment providers has supported their work to improve treatment and reduce harm.
New clause 17—Minimum unit price for alcohol—
“(1) The Secretary of State must by regulations make provision to ensure alcoholic drinks, as defined by the Department for Health and Social Care’s Low Alcohol Descriptors Guidance published in 2018, or in later versions of that document, are liable to a minimum unit price.
(2) The regulations must provide for the minimum unit price to be calculated by applying the formula M x S x V, where—
(a) M is the minimum unit price, expressed in pounds sterling,
(b) S is the percentage strength of the alcohol, expressed as a cardinal number, and
(c) V is the volume of the alcohol, expressed in litres.”
This new clause requires the Secretary of State to introduce secondary legislation that applies a minimum unit price to alcohol.
Amendment 14,in clause 138, page118,line5, after “drink)”, insert
“and section [Minimum unit price for alcohol]”.
This amendment would bring NC17 into force at the same time as section 129 and Schedule 16 (advertising of less healthy food and drink).
Amendment 3, in schedule 16,page222,line8, at end insert—
“(3) A brand may continue to advertise, or provide sponsorship, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.
This amendment makes an explicit exemption from the advertising restrictions on television programme services between 5.30 am and 9.00 pm for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendments 31 and 32.
Amendment 11, in schedule 16,page222,line26, at end insert—
“(da) a drink product is ‘less healthy’ if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.
Amendment 111,in schedule 16, page222,line28, leave out from “meaning” to end of line 30 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
This amendment, and Amendments 112 and 113, aims to define companies to whom the advertising restrictions imposed by this schedule would apply as medium-sized companies within the meaning given by section 465 of the Companies Act 2006.
Government amendment 33.
Amendment 6,in schedule 16, page222,line38, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on television programme services between 5.30 am and 9.00 pm.
Amendment 4, in schedule 16,page223,line4, at end insert—
“(3) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement or sponsorship does not include an identifiable less healthy food and drink product.”.
This amendment makes explicit exemptions from the advertising restrictions on on-demand programme services for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendments 34 and 35.
Amendment 12,in schedule 16,page223,line24, at end insert—
“(da) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the watershed proposed for TV programme services.
Amendment 112,in schedule 16,page223,line26, leave out from “meaning” to end of line 27 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
See explanatory statement to Amendment 111.
Government amendment 36.
Amendment 7,in schedule 16,page223,line36, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted on on-demand programme services.
Amendment 106,in schedule 16,page224,line8, leave out “must not pay for” and insert
“must not market, sell or arrange”.
This series of connected probing amendments is intended to create parity in treatment of television and online advertising. The platform carrying the advertising, rather than those paying for advertising, would be responsible for the placing of advertisements. The wording to denote a platform mirrors that used by Ofcom in its recent regulation of Video Sharing Platforms consultation.
Amendment 110,in schedule 16,page224,line16, at end insert—
“(aa) in relation to advertisements placed on distributor or retailer websites which are associated with the sale of food or drink”.
This amendment aims to ensure paid-for branded HFSS product advertisements are treated as equivalent to HFSS own-brand products on retailer-owned spaces.
Government amendment 37.
Amendment 5,in schedule 16,page224,line26, at end insert—
“(4) A brand may continue to advertise, and provide sponsorship as a brand, if the advertisement does not include an identifiable less healthy food and drink product.”.
This amendment makes an explicit exemption from the restrictions on online advertising for brand advertising and sponsorship, where there is no identifiable less healthy food and drink product.
Government amendment 38.
Amendment 13,in schedule 16,page225,line10, at end insert—
“(fa) a drink product is “less healthy” if it is an alcoholic product in accordance with the Department for Health and Social Care’s Low Alcohol Descriptors Guidance, published in 2018, or future versions of that guidance;”.
This amendment ensures that alcohol is considered a “less healthy” product and therefore liable to the online ban.
Amendment 113,in schedule 16,page225,line12, leave out from “meaning” to end of line 14 and insert
“given in Section 465 of the Companies Act 2006 (Companies qualifying as medium-sized: general)”.
See explanatory statement to Amendment 111.
Government amendment 39.
Amendment 8,in schedule 16,page225,line24, after “unless”, insert
“a public consultation has been carried out on the proposed change to the relevant guidance, and”.
This amendment requires a public consultation to take place before any change can be made to the Nutrient Profiling Technical Guidance under which a food or drink product may be identified as “less healthy” and its advertising restricted online.
Amendment 107,in schedule 16,page225,line28, leave out “made a payment for” and insert “marketed, sold or arranged”.
See explanatory statement for Amendment 106.
Amendment 108,in schedule 16,page225,line30, leave out “made” and insert “received”.
See explanatory statement for Amendment 106.
Amendment 109,in schedule 16,page227,line3, leave out from “with” to end of line 4 and insert
“the person marketing, selling or arranging advertisements published on the internet”.
See explanatory statement for Amendment 106.

Mary Foy: Before I address the amendments tabled in my name, I want to briefly voice my support for amendments 11 to 13 and new clauses 15 to 17, in the name of my hon. Friend the Member for Liverpool, Walton (Dan Carden), which call for improved regulation of alcohol marketing and labelling, for minimum unit pricing in England and for better assessment of treatment outcomes. Sadly, my hon. Friend cannot be here today, as he is with his family and his father Mike, who is receiving palliative care after many months of treatment for lung cancer. I know how important these issues are to my hon. Friend; I express my love and solidarity, and that of the whole House, at this difficult time for him and his loved ones.
Smoking is one of the biggest causes of ill health. It has a devastating impact on our population: it killed approximately the same number of people in 2019 as covid 19 in 2020, and one in every two smokers will die from smoking-related illnesses. The Government and the Opposition both support a smoke-free 2030, but without meaningful action, that ambition will be missed by seven years—or by double that number of years, in the case of the poorest in society.

Catherine West: Does my hon. Friend agree that Professor Marmot’s work on social and health inequalities shows that 0.5% of GDP should be spent on health inequalities such as those she describes?

Mary Foy: I could not agree more. Michael Marmot is one of the most important health inequalities experts around.
To make matters worse, smoking rates among young adults have surged to 25% above pre-lockdown rates. However, despite the damage that missing the 2030 target would cause, there is nothing in the Bill that would help to achieve the Government’s ambition to make smoking obsolete. That is why the all-party parliamentary group on smoking and health, of which I am the vice-chair, is fighting to get the 2030 ambition back on track. I was delighted to hear the Minister say in Committee that the Government would review the APPG’s proposals as they developed their own tobacco control plan, but that plan, which was due this year and expected in July, is now likely to be delayed beyond the end of the year. If the Government are serious about creating a smoke-free England by 2030, they will implement the APPG’s recommendations as soon as possible, and the Bill provides the ideal opportunity for them to do so.
Let me quickly summarise new clause 2. It gives the Secretary of State powers to add health warnings to cigarettes and cigarette papers. The Government are reviewing the proposal, but have said that more research is needed. Health warnings such as “Smoking Kills” have been shown to be effective on billboards and tobacco packs, so why on earth would they not be effective on individual cigarettes? At least eight peer-reviewed papers have been published in the last five years showing that the measures are effective. Similarly, new clause 3 would give the Secretary of State powers to require health information messages to be inserted in cigarette packs. That has been a legal requirement in Canada since 2000, and there is substantial evidence to show that it works there. Research carried out in the UK supports its use here as well.

Jonathan Edwards: The hon. Lady will, of course, understand that one of our key aims must be to stop younger generations taking up smoking in the first place. Does she believe that her proposals—which I fully support—will help to achieve that key strategic aim?

Mary Foy: Most of my new clauses are indeed intended to prevent young people from starting to smoke in the first place.

Hywel Williams: The hon. Lady has said that these measures apply to England, but they will of course have an effect throughout the United Kingdom—and rightly so—contributing to our aim to bring about a smoke-free Wales as well.

Mary Foy: Again, I could not agree more.
In Committee, the Minister said that the Department could already legislate under the Children and Families Act 2014 to require the insertion of such information messages. In that case, why do the Government not commit themselves to doing so now?
New clauses 4 to 6 address loopholes in current legislation. Now that those loopholes have been identified to the Government, they should be fixed without delay, and today we have the opportunity to do so. New clause 4 would give the Secretary of State powers to remove child-friendly branding elements from nicotine products. There are e-liquids on the market that are given sweet names, such as “gummy bears”, and that have branding that is in garish colours and features cartoon characters. Surely more evidence is not necessary to prove that such branding risks attracting children.

Philippa Whitford: Is this not one of the most important of the hon. Lady’s new clauses? As people age and die—events often driven by cigarettes—or perhaps manage to give up, the tobacco companies must recruit the young, with the indefensible aim of persuading them to start smoking.

Mary Foy: I entirely agree. Tobacco is the only legal product that kills one in two of those who use it, and most people start smoking at a young age. These new clauses are therefore extremely important, because they would tackle that problem.

Jim Shannon: The figures back up what the hon. Lady says. Two thirds of smokers in the UK start smoking under the age of 18, and over a third—39%—start under the age of 16. What she proposes will address that issue in a substantial way. We need legislation in place, and there needs to be punishment as well; that is the only way forward.

Mary Foy: I thank the hon. Gentleman, and I will address that issue.
New clause 5 would close another loophole in the law, which allows the free distribution of e-cigarettes and other consumer nicotine products to children under 18. The Government rejected the proposal, saying that there was no evidence of a serious problem, but the Minister sympathised with the argument for preventive action. Prevention is precisely our intention. Fixing this loophole is an appropriate application of the precautionary principle.
New clause 6 would remove the limitations on the ban on flavourings in tobacco products. That ban currently applies only to characterising flavours. The new clause would extend the flavour ban to all tobacco products, as well as to smoking accessories, including filter papers, filters and other products designed to favour tobacco products. In Committee, the Minister claimed it was unclear how a ban could be enforced in practice, as it would include a ban on flavours that did not give a noticeable flavour to the product. I suggest that he seek advice from Canada on this point, where a complete ban on flavours is already in place and has been highly effective.
The new clauses on the tobacco levy would give powers to the Secretary of State to implement a “polluter pays” levy on tobacco manufacturers. The Minister dismissed this in Committee as a matter of taxation for the Treasury to consider. However, we are not proposing additional taxation. Our new clauses are modelled on the American user fee and on the pharmaceutical pricing scheme in the UK.

Janet Daby: Does my hon. Friend agree that prevention is much better than cure, because so many adult smokers have a terrible experience when trying to give up, and it comes at a huge cost to their health?

Mary Foy: I thank my hon. Friend for that intervention. A theme throughout these new clauses is that most people start smoking when they are children or when they are young, and most of them say that they wish they had never started. The new clauses would tackle young people’s access to tobacco-related products.

Paula Barker: It is often vulnerable children, and often those in care, who start smoking early, so does my hon. Friend agree that it is incredible that the Government have so far said that they will not support these new clauses?

Mary Foy: Yes, it is absolutely incredible. We have heard that a tobacco plan might be on its way, but every day that goes by without our putting these recommendations in place is another day on which someone dies of tobacco harm, and on which more young people become addicted to nicotine products.
Discussions with the Treasury on the “polluter pays” levy would not be necessary. The Food and Drug Administration administers the user fee in the United States, and the Department of Health and Social Care could and should administer such a scheme here.
New clause 11 has been revised in the light of the Government’s response to our proposal in the Committee, in which they cited the need to
“review the evidence base of increasing the age of sale to 21 in more detail”.––[Official Report, Health and Care Public Bill Committee, 28 October 2021; c. 816.]
They also stated the need for a public consultation. I agree that a consultation is the appropriate next step, so the new clause has been revised to require the Government to consult on raising the age of sale for tobacco from 18 to 21 within three months of the passage of this legislation.
To sum up, my new clauses address loopholes in the law. They would take incremental and obvious next steps to strengthen tobacco regulation still further, and they would provide the funding that is desperately needed  to deliver the Government’s smoke-free 2030 ambition—funding that the spending review failed to deliver. When I was chair of the Gateshead tobacco control alliance, I saw the damage that smoking can do. It shortens life expectancy, increases the pressure on our health services, drives down productivity and drains wealth from our poorest communities—and for one in every two smokers, it will kill them. Eventually, the Government will have to accept that the measures proposed are necessary. The only question is how long they will wait, and how many lives will be ruined by tobacco in the meantime. I urge the Government to accept these new clauses in full.

Greg Smith: I rise to speak in this debate to outline the case behind amendments 106 to 109 in my name, and to speak in favour of those in the names of my hon. Friends the Members for Carlisle (John Stevenson) and for North East Bedfordshire (Richard Fuller). I am also grateful from the outset for the time that my right hon. Friends the Secretaries of State for Health and Social Care and for Digital, Culture, Media and Sport have afforded me in recent weeks to discuss these matters.
First and foremost, I want to set out that in principle I am opposed to the expansion of the nanny state. I did not get into politics to tell people what they should or should not eat, or businesses how they should go about advertising their products and wares. However, I equally do not doubt for one moment that obesity is a serious health concern for this country. It is a question of the detail and the manner in which we go about tackling it as a country—principally, that we go about it through education and ensuring people are able to make choices for themselves, rather than using blunt tools that I fear will not work. As I highlighted in a Backbench Business debate on the obesity strategy some months ago, the Government’s own research shows that the measures in the Bill will reduce calorie intake among children by only 1.74 calories a day. If that is the outcome, we must seriously question the measures before us.
The amendments in my name, however, seek to rectify an unfairness that will exist if the Government push ahead with these advertising restrictions, which have businesses in my constituency very concerned. For example, farmers such as Morris of Hoggeston, who grow oats, are concerned that within the categories under the HFSS, or high in fat, sugar or salt, measures, products such as porridge and granola, which are hardly the choice of most children—certainly not my children—are in scope. We need to do something to sort that out. Great British broadcasters, both public service and fully commercial, also stand to lose some £200 million a year from the restrictions we have before us.
My amendments are about fundamental fairness, and seek to treat broadcasters the same way as online platforms. In the first place, research shows that children, who these measures are most prominently aimed at, do not watch broadcast television as much as they used to. They look more and more to YouTube, on-demand services and online; I can testify to that from my own home, where my five-year-old much prefers YouTube to watching CBeebies or other children’s television programmes, and I think that is the same for most children. [Interruption.] I am not sure what is causing amusement on the Opposition Benches.
In fact, 95% of viewing of broadcast television before the 9 pm watershed is by adults, not children, and there are already regulations in place during scheduled children’s programming. So I fear the measures in this Bill will not work, and the fundamental unfairness that I spoke of earlier is the manner in which broadcasters will be treated compared with the online platforms.

Barry Gardiner: I have listened carefully to what the hon. Gentleman has said. Given that there is this disparity between the online advertiser and the broadcaster advertiser, and if we are seeking to restrict broadcasting advertisement to children so that they do not become unhealthy, would not the logic follow that we should equally restrict the online advertiser, rather than saying, “Let’s allow more of a free for all because this is more difficult to do for the online”?

Greg Smith: I am grateful to the hon. Gentleman for his intervention. If he will let me make a little more progress, I think he will find that my amendments seek to put a harsher perspective of this on the online platforms, rather than letting anyone off anything whatsoever. I repeat that my fundamental position is one of opposition to the nanny state and restrictions, but recognising that if the Government are going to push these restrictions forward, we have to have fairness and parity across broadcast and online sectors, otherwise there will be loopholes, things will fall through the cracks and the Government will not achieve their objectives.

Alun Cairns: I certainly support the argument that my hon. Friend is putting forward. Does he feel that the Government have found themselves in a position where they feel they need to react because of the genuine obesity crisis among young people and this would seem to be the highest-profile publicity effort, but that really we should be focusing on the evidence of the case and the argument, so that we can actually have an impact on it, rather than steal the headline that might just last a couple of days?

Greg Smith: My right hon. Friend has hit the nail on the head: if we are to tackle obesity as a country, we have to look at the most successful outcomes. Fundamentally, I believe those to be ones of education, ensuring that parents are empowered to be able to make the best decisions for their children and ensuring that people are empowered to come to the right choices for themselves. The point about these amendments is to ensure that we are not giving a green light to one side while harshly penalising another for hosting these adverts.
The nub of the point is that the broadcasters will, in effect, have to pre-clear any advertising that is put on to their platform and there will be very harsh penalties, leading right up to the point of revocation of their broadcast licence, if they fail to do this. By contrast, although the Bill puts significant restrictions on the online platforms, they are not put through that same test. They are not put through the same harsh restrictions and requirements that are broadcasters are. This is especially important when we consider recent evidence that has been put into the public domain. The Advertising Standards Authority recently drew considerable attention to the mass flouting of the rules by online influencers across many sectors. This House’s Select Committee on  Work and Pensions made an important point about online regulation in a report in March this year on protecting pension savers. It said:
“Regulators appear powerless to hold online firms to account”—
for online advertisements—
“in the same way they would be able to for traditional media.”
We need to bear that in mind as we consider this Bill, because if current regulations do not work in that field, I fear that the regulations on online providers proposed in this Bill will not either.
I offer these amendments as a call to those on the Treasury Bench, including the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar)—an excellent Minister who will consider these points carefully—to rethink the practicalities of what we are saying to the broadcast and online sectors. If the Government are intent on pushing this forward, I ask them to find that parity that ensures that broadcasters are not unfairly penalised. Great British broadcasters—ITV, Channel 4, Channel Five, Sky—already produce some incredible educational programming about diet, cooking, wellbeing and lifestyle. It would be horrendous for us to cut off their lifeline of funding.

Karen Bradley: I have put my name to my hon. Friend’s amendments because I agree with the points that he makes.
It is surely vital that those responsible broadcasters should not be penalised when they are doing the right thing—and yet there is effectively a wild west on the internet, where we are simply not able to manage the issue. I recognise that the Minister will be concerned that the online harms Bill will also deal with some of these matters, but we need to find a cross-Government way of dealing with this.

Greg Smith: My right hon. Friend is absolutely right and speaks with great experience from her time as Secretary of State at DCMS. That is the fundamental point of the amendments; it is not a complex or difficult case, but purely one of fairness and treating the different platforms—the diverse media of 2021—the same, rather than pretending that the media from the old analogue age can somehow be treated differently from those of the digital age.
Let us not cut off the lifeline that funds so many good educational programmes. Let us think again about restrictions on advertisers, move forward in a way that can enable people to make the right and healthy choices about what they and their children eat without this level of restriction, and ensure that, when restriction is brought in, it is fair.

Alex Norris: It is a pleasure to speak for the Opposition in this first part of the debate on the Bill.
A decade ago, virtually to the day, I was a young activist taking part in marches, protests, online campaigns, letter writing campaigns, petitions and much more in opposition to what would become the Health and Social Care Act 2012. We argued that it would lead to more  fragmentation, less integration, confused decision making and more privatisation and that it would not make anybody any healthier.
Despite significant opposition to the legislation, the Government pushed on. But as campaigners, we were right, weren’t we? The 2012 Act created a fragmented system that did not promote health and care integration. Performance against NHS targets, even pre-pandemic, was dismal and now it is even worse. Waiting lists have grown extraordinarily, and staff vacancies have grown to crisis proportions.
We are here today and tomorrow to consign that legislation to history—perhaps less the end of an era and more the end of an error. But the same Government who broke the system now offer a new package of reforms, and that should really scare us. These are the wrong reforms at the wrong time. There are no answers in them to the waiting times crisis, no answers to the capacity issues in accident and emergency or our ambulance services, no answers to access issues for our GPs or dentists, and no answers to the environmental factors that make a country with so many assets so unhealthy.

Mike Amesbury: Does the shadow Minister agree that the Bill gives the green light to private profit making companies sitting on integrated care organisations?

Alex Norris: Yes. That was a strong theme in Committee that we on the Opposition Benches are very much against; it is likely to be a prominent theme during our discussion of upcoming amendments. Through what we are discussing now, we at least have the chance to put something in the Bill that might improve the public’s health.

Barry Gardiner: My hon. Friend talked about waiting lists. Would he confirm that at the moment approximately 5.6 million people are on the waiting list and that the Government’s own projections are that that figure could rise to 13 million? What in the Bill does my hon. Friend believe can address that extraordinary situation?

Alex Norris: My hon. Friend makes an important point. This Secretary of State must be the first in the history of the NHS who came into that important role saying that he was expecting waiting times to grow to the extent that they are. That is of course pandemic-related, but it also has a reality far beyond this extraordinary last 18 months. There are more than 125 clauses in the Bill and the Government have proposed more new clauses in Committee and on Report, but not one of them will have a meaningful impact on waiting times, so people should be really disquieted.

Alun Cairns: I have listened carefully to the hon. Member’s comments about waiting times in England and the measures that are to be introduced here. He urged disquiet; can I assume that his disquiet is even louder when he considers my constituents in Wales who have much longer waiting times?

Alex Norris: There is a danger that the right hon. Gentleman has missed the point. The reality is that for a decade there has been historically low investment in our health service, which of course has Barnett consequentials  for Wales. That is the reality and why the system is as distressed as it is. I do not think he can put that at the door of the Welsh Government.
Let me come back to public health. Over the past five years we have removed £1 billion in public health funding, which means that the challenges in respect of childhood obesity, smoking, sexual health and access to drug and alcohol services are all developing and growing. The sad thing is that such cuts make an immediate local government saving for the Treasury but create greater costs for the public purse later, never mind the impact on people’s lives. They are the falsest of false economies. For all the talk of the end of austerity, last month’s Budget did nothing to tackle that reality. Indeed, local authorities are under greater pressure and the cycle will continue.
Being smoke-free by 2030 is a major national prize, and with that I turn to new clauses 2 to 11, tabled by my hon. Friend the Member for City of Durham (Mary Kelly Foy). She made an excellent case and has shown tremendous leadership on this issue, in concert with the hon. Member for Harrow East (Bob Blackman), through the all-party parliamentary group on smoking and health. They have given the Government a number of really good ways to improve our nation’s efforts and I hope we will hear from the Minister that they will be taken on.
Tackling smoking is a crucial part of not only improving the nation’s health but addressing health inequalities. A child born where I live, Nottingham, can expect to live seven years fewer than a child born here in Westminster. When it comes to healthy life expectancy, we can expect that difference to double. Tackling that inequality should be a core part of the business of this place. Nearly half that inequality is attributable to smoking—that is how pivotal this issue is.
Successive Governments have shown over the past 25 years that we can make inroads with public policy on smoking, but the benefits have been unevenly felt: the smoking rate among those in professional occupations is now down to just one in 10, so is well on track to meet the 2030 target, but incidence rates among those in manual or routine occupations remain a stubborn one in four, so we must now renew our efforts with that group of people who are, of course, disproportionately likely to use stop smoking services—the very services we have lost over the past decade. Of course, as my hon. Friend the Member for City of Durham said, the pandemic has posed new challenges, with a new group of people who have started smoking but would not otherwise have done so.
We have been promised a new tobacco control plan by the end of this year, but that promise looks a little less secure by the day—I hope the Minister will tell me I am wrong. We could get on with impactful interventions right away. The labelling and information interventions set out in new clauses 2 to 4 have very strong evidence bases from other countries, as my hon. Friend the Member for City of Durham said, and would be quick, easy to implement and impactful.
On new clause 4 in particular, we know that e-cigarettes and vaping are important quit aids, but we would not want them to be a gateway for children to smart smoking. We should be concerned about the 2021 YouGov research for ASH—Action on Smoking and Health—that suggests that more than 200,000 11 to 17-year-olds who had never smoked previously had tried vaping this year. As  my hon. Friend the Member for City of Durham said, we must make sure that that age group does not take smoking through that route and that products are not targeted at it.
New clause 5 would tackle the bizarre loophole, which colleagues sometimes struggle to believe is true, that would allow the egregious practice whereby e-cigarettes or similar kit could be given free to someone under 18, although they cannot be sold. That is an extraordinary part of the law and I know that the Minister agrees it is daft—he said that in Committee, but also that he did not feel there was quite the evidence that it was a risk. Well, risk or not, I think the loophole should be closed, because I suspect that eventually someone will happen on it as a bright idea.
New clauses 8 and 10 are a beautiful support to any Minister who wants to improve smoking outcomes in this country, as I know this Minister does, but is conscious about the finances. This gives the Minister a chance, through a US-style polluter pays model, to fund all these interventions, including the restoration of the lost smoking cessation services in this country. He did not close the door to that in Committee when we talked about it, so I hope that he might tell us today that it is likely to form part of the new tobacco control plan. New clause 11 promotes a consultation on raising the age of sale, as we know that the older a person gets, the less likely they are to start smoking.
Let me turn to new clauses 15 to 17 and amendments 11 to 14 in the name of my hon. Friend the Member for Liverpool, Walton (Dan Carden). Colleagues will have been profoundly moved to hear him speak of his battle with alcoholism, and I know that his bravery has connected with people across the country. I associate myself with the remarks of my hon. Friend the Member for City of Durham regarding his entirely understandable absence from the Chamber today. With him in mind, I speak in support of those new clauses and amendments.
New clause 15 seeks to improve alcohol product labelling. This is overdue and it is popular. It is about not taking alcohol products out of people’s hands, but instead making sure that they can make an informed choice.

Christian Wakeford: While an energy drink carries not only calorific information but a health warning that drinking too much can have a laxative effect, alcoholic drinks carry no calorific information and no health warning. Does the hon. Gentleman agree that that is a damning indictment of where we are in society and that a change, which the amendment could make, is needed?

Alex Norris: I am grateful to the hon. Gentleman for that intervention. I completely agree with him. I would be the last one to police people’s consumption habits in the night-time economy for fear of being a hypocrite, but I do think that we should all have informed choice. What we have at the moment is inconsistent and unclear. We know that that frustrates people. A recent survey has shown that: 75% of people would like to know the number of units in a product; 61% would like to know the calorie information, as he mentions; and 53% would like to know the amount of sugar. We should give people the chance to have that full information to make their own decisions.

Geraint Davies: My hon. Friend will know that two thirds of people in Britain are overweight and that one in four is obese. An enormous amount of added sugar is put into processed foods that people do not know about. Men, for instance, are not supposed to have more than nine teaspoons of added sugar, and women six, which is the equivalent of a can of coke and a light yoghurt. Does he not agree that this Bill is tremendously light on the killer that sugar is, and that not only should we be labelling it, but that the Budget should tax added sugar in processed food to reduce the waiting list?

Alex Norris: My hon. Friend will be delighted to hear that I will be coming on to the modesty of the Government’s plans for tackling obesity, but I have to finish my remarks about new clause 16.
New clause 16 compels the Secretary of State to publish an annual statement about the spend and impact of alcohol treatment funding. After a decade of reduced commitment in this vital area, the Secretary of State should seek to embrace this opportunity. At the moment, national Government cannot say they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right place, which should discomfort them greatly. New clause 17 would replicate in England the minimum unit pricing restrictions that we see in Scotland and Wales, and we are all watching with great interest as evidence gathers as to their impact.
Let me now turn to the amendments and new clauses relating to advertising. The Government have included a couple of elements of their obesity strategy in the Bill. As I have already said to the Minister—in Committee and upstairs in the delegated legislation Committee—I wish that they had put the entire obesity strategy in this legislation, because there are bits that could have been improved by amendment, by debate and by discussion, as we heard in the contribution of the hon. Member for Buckingham (Greg Smith), and as I dare say we will in that of the hon. Member for North East Bedfordshire (Richard Fuller). We should have taken that approach to the entire document, and it is sad that we did not.
On the obesity strategy itself, it is too modest and it fails to attack a major cause of obesity, which is poverty.

Jim Shannon: The hon. Gentleman is absolutely right in what he is saying. I am a type 2 diabetic and I am well aware of the issues. As I understand it, figures that have been gathered during the covid-19 pandemic showed that the number of diabetics rose by some 200,000. That tells me that, if we are going to address the issue of diabetes, we need to have a tax process in place, which I think is what the hon. Gentleman is referring to, rather than a regulation, because that is the only way that we can control diabetes.

Alex Norris: I think that a solution might be a little from column A and a little from column B, but I am grateful to the hon. Gentleman for making that point.
We have heard about the modesty of the strategy from the hon. Member for Buckingham. The reality is that any benefits from the obesity strategy will be outstripped by losses in the nation’s health caused by the impact of the cut to universal credit. We want the strategy to succeed, but it needs to be seen in that broader category.
Obesity is an important issue, with nearly two thirds of adults carrying excess weight. Childhood obesity is also a significant issue, with one in 10 children starting primary school obese, rising to one in five by the time they leave—extraordinary at such a young age.

Catherine West: I thank the shadow Minister, who is making an excellent argument, and colleagues across the House for all their work on this important Bill. Does he agree that we could do an enormous amount for the health of the nation by looking holistically at the role of exercise and prescribing exercise through the national health service, including swimming—the statistics on 11-year-olds who can swim 25 metres are going backwards due to all the lessons they have missed during coronavirus—and other important sports?

Alex Norris: Yes, I agree. I look with real sadness at the loss of exercise-on-prescription schemes that were part of the public health grant but have gone over the last decade. Similarly, on swimming, the decisions in the Budget relating to local authorities will lead to councils, which are setting their budgets as we speak, closing more leisure centres and swimming pools. We should mourn those losses, which come as a result of a weak bit of public policy.
In the Bill, the proposed watershed with regard to high fat, sugar and salt products is broadly a good thing. With that in mind, we do not oppose Government amendments 31 to 39, which are relatively modest tweaks, but we should not lose sight of the fact that we are talking about a significant proposal; I know that colleagues have interest in this. Beyond a watershed on traditional broadcast media, we will also see a complete online ban of high fat, sugar and salt advertising. This is a blunt tool in pursuit of an important goal.
New clause 14 in the name of the hon. Member for North East Bedfordshire would implement a more nuanced system, as proposed by the advertising industry itself. This is mirrored in amendments 106 to 109 in the name of the hon. Member for Buckingham. We probed this point in Committee. I was surprised then, and remain surprised, that there seems to be little interest from Ministers or the Department in even having that conversation and exploring creative alternatives. The desired benefits are non-negotiables. If there are other ways to achieve those benefits, they ought to be approached with an open mind.

Richard Fuller: I am grateful to the hon. Gentleman for mentioning my new clause. We have a number of issues potentially to put to a vote later. Given what he has said and given that the Minister was a bit hazy about this issue in Committee, would he be minded to support my new clause if it were put to a vote and the Minister did not come forward with something more robust?

Alex Norris: The hon. Gentleman tempts me, but my problem is that I want to know that the conversations have taken place and that the proposal has been considered as an option. I would not say today that I think it is the best option, but I am surprised that that conversation has not taken place, which is why I have highlighted it. There is still time for the Minister to reconsider, and  he should.
I was less persuaded by amendments 3 to 5 in the name of the hon. Member for North East Bedfordshire, which seek to permit brand advertising as long as it does not refer to an HFSS product. In many cases, the brand and product are so inexorably intertwined that it might undermine the goals and aims of the whole intervention. I do, however, support amendments 6 to 8, which refer to the nutrient profiling model—the model that is used to determine what is and is not considered to be a high fat, sugar and salt product. It is important that there is certainty and that it does not move around more than the science would say that it ought to.
We talked about this issue at length in Committee. If we are asking the industry to reformulate and change, companies ought to be able to base product decisions on the certainty that the Government will not arbitrarily change the criteria. Such companies may have made significant time, financial or infrastructure investments in a certain product and then could see the criteria change overnight. In Committee, we extracted a commitment from the Minister to a Government amendment on this matter. That was reiterated in a letter on 13 November, when the Minister wrote to Committee members and committed to
“introducing a Government amendment at Commons Report Stage to include a duty to consult before changing the NPM technical guidance.”
I am surprised not to see that at this point. I hope that we will get clarity from the Minister, or indeed that he is minded to accept these amendments, because this is an important development. We also want the level playing field suggested by amendments 110 to 113, so we will be listening with great interest to his reply.
This is the wrong Bill at the wrong time. It does nothing to address the real causes of ill-health in this country today. In this part of the proceedings, colleagues have given the Minister a chance to change that and I hope he is minded to take it.

Richard Fuller: It is a great pleasure to follow the hon. Member for Nottingham North (Alex Norris). I will speak to new clause 14 and the other amendments in my name. I am grateful for the Opposition’s support for amendments 6, 7 and 8 and for an industry-led alternative—in spirit, if not necessarily in voting. I think the hon. Gentleman, as well as many of my hon. Friends, will be wanting to hear something from the Minister to show that he has been listening to concerns that have been raised across the House.
I was surprised and delighted to see on some of my amendments the name of the hon. Member for Central Ayrshire (Dr Whitford), but she advised me that that was an error, so I am sorry that the potential amity between me and those on the Scottish National party Benches will have to wait for another day.

Philippa Whitford: I am grateful to the hon. Gentleman because that has saved me from having to put a disclaimer at the start of my speech, as I was rather shocked to find my name on his amendments. I just reiterate the point made by the hon. Member for Nottingham North (Alex Norris). It is a concern that the names of companies, as we saw in F1 racing and other things, simply promote certain types of food and drink and you cannot separate the brand from the product.

Richard Fuller: I am grateful to the hon. Lady for making her point clear.
As the hon. Lady and other hon. Members know, my amendments relate to the ways in which the Government are seeking to restrict advertising for foods that are high in fat, sugar and salt as part of their obesity strategy. Those measures essentially ban such advertising on TV before the 9 pm watershed and ban all paid-for HFSS advertising online at any time of the day or night. My hon. Friend the Member for Buckingham (Greg Smith) has already done a very good job in drawing out some concerns about that.
What are the concerns about what the Government are doing? First, I should mention that I have a number of important food businesses based in my constituency, including Unilever and the cereal company Jordans Dorset Ryvita, and I think everyone would be surprised to hear that products such as porridge, muesli and granola are going to be subject to these bans. All these products have ingredients such as naturally occurring oils and sugars, as well as fibre, vitamins and minerals, and because of those natural ingredients they will be caught by the Government’s definition of “HFSS”.
It is also worth considering—I was not on the Committee and I do not know if it was considered at length—the impact on food services such as takeaways and home-delivered foods. Papa John’s, which is located near me in Milton Keynes, supports hundreds of entrepreneurs and small businesses through its franchise model, and it writes to warn me:
“These would restrict our ability to invest in our businesses and our people, at a time of significant economic uncertainty for the UK economy, and would also place our franchisees, many of whom are single owner small businesses, on an unsustainable financial footing.”
I think the Government have to do a few more hard yards in support of our small businesses, and this is not a very good way of showing any support for them.

Jim Shannon: The number of diabetics, both type 1 and type 2, across the United Kingdom and the number of children with obesity is rising. Does the hon. Gentleman feel that new clause 14 cannot address the issue of those rising numbers? If it cannot, what more needs to be done?

Richard Fuller: I absolutely do not agree. The reason why the Opposition Front-Bench team are probing on this is that we are not harnessing all the talents to come up with the solution. As the hon. Member for Nottingham North said, he does not have, or want, any objection to the objective—he just feels that there may be better ways to do it. That is what my amendments are trying to create. They would introduce a better way, working with established principles and with the industry—let us face it, it has the experts in this—rather than undermining issues to do with how the Advertising Standards Authority has managed how products are advertised and rather than bulldozing through the industry, which is the current process that the Government, or this Department anyway, are proposing.
Let us just remember that this pressure on our food and drink manufacturers is part of a wider effort of social responsibility that we are putting on them. The proposal does not sit alone, but with other things, in particular around environmental protection. The Food and Drink Federation has calculated that the cost of  the UK Government’s proposed environmental health policies is at least £8 billion. That is equivalent to £160 a year on household food bills that we are asking the industry to take on.
It is estimated that the introduction of this policy will cost £833 million, but the Government’s own impact assessment estimates that the benefits are likely to be in the order of only £118 million. That is a real dead loss that we will be putting, let us face it, on food bills, primarily of those in lower income brackets. Members on all sides should take a moment to consider whether this is the right time and the right process for doing that. As the Government’s own assessment shows, the actual effect on diet for those who are targeted is estimated to be 1.7 calories a day, so it is a lot of effort and cost, but not very much impact.
New clause 14 proposes an alternative that would require the regulator to implement an alternative set of increased restrictions for online, but developed through the industry by the Committee of Advertising Practice. The new clause would legislate for a three-step filtering process drawn up by the industry to appropriately manage the targeting of online ad campaigns.
Another of my amendments would introduce brand exemptions. I take a different view from the hon. Member for Central Ayrshire, who said that brands are intrinsically tied to their product. The truth of the matter is that Coca Cola is made by Coke and Coke Zero is made by Coke. Coke Zero is advertised with the word “Coke” on it. This issue is not necessarily covered by the legislation, but Coke is not tied to one thing. Brands are extraordinarily flexible in how they can assist progress in achieving some social means. The Minister should consider looking again at this area.
Finally, on the nutritional profile, the issue is consultation. I can see that the Secretary of State has tabled some amendments on that, and perhaps the Minister can talk about that. They do not seem to make the changes I would like to see, but I would be interested to hear what he has to say.
It is worrying that the Government have undermined the Advertising Standards Authority with their approach. One of the other things is targeted advertising. I am sure it has struck hon. Members here as it has me that the tech revolution of the dotcom era was 20 years ago, and two decades of technical expertise in understanding how adverts are targeted is being swept away or ignored by the Department of Health and Social Care, which would much rather have “nanny knows what’s best”. The truth of the matter is that, by harnessing technology, the Government could get a better outcome than this official ban. As my hon. Friend the Member for Buckingham said, there are plenty of other ways to do it that would be hard for advertisers to get around.
I say to the Minister that I am trying to be helpful, as always, and, to be serious, as are the Opposition. The Government have made a slight misstep by adopting a top-down, state-driven model. I say to the Minister that the path of good intentions is littered with unintended consequences. The essence of conservatism is not to use the state to bully or, as perhaps the advisers in the various Departments say in modern parlance, to nudge. It amounts to one and the same thing. The Department’s attempt to censor products such as these is profoundly un-Conservative. Our party believes in individual  responsibility and that families are the foundation of society where choices and power in society most naturally lie. Nowhere is that more important than in health matters, yet these proposals extend the role of the state and undermine parental responsibilities.
The measures make the Department of Health and Social Care look like a new outpost of cancel culture that denies free speech and has a predisposition that individuals should conform to what the state determines, rather than enabling informed free choice. It is desperately sad to see them being pushed through by a Conservative Administration. I say to my colleagues on the Back Benches: when will we wake up and realise that we need a Government who support free enterprise and individual responsibility, and who understand that the way to create growth in the economy is through enabling people to make free choices, rather than expecting the state to be the answer to every problem? With that question, I will wait to listen to what the Minister has to say.

Philippa Whitford: I thank the hon. Member for North East Bedfordshire (Richard Fuller) for clarifying that I had not voluntarily added my name to his amendment.
Whenever we talk about such subjects, we hear a lot about the nanny state. As a surgeon working in A&E in general surgery, however, the difference when seatbelts, airbags and speed limits came in was night and day in how much time I spent dealing with people in operating theatres who had been involved in car crashes. Sometimes the state has to take action to protect people’s health and wellbeing.
The Bill focuses largely on reversing some of the most egregious aspects of the Health and Social Care Act 2012, which I welcome, but these measures focus on improving public health. There is no question that obesity, type 2 diabetes and other diseases associated with obesity pose not just a real threat to individual health but a threat that will overwhelm national health services in future. When I looked at the original Bill, however, I was surprised that, apart from the measures around obesity, there was little in the way of public health policy to improve and promote health, and there is also little enough about care.
It is not the national health service that delivers health. I have often said that it would be more appropriate to call it the national illness service, but who would want to work somewhere called that? The NHS spends most of its time catching people when they fall. Health comes from a decent start in life, a warm dry home, enough to eat and a decent education. Those are the things that deliver health, but there is nothing like them in the Bill.
Particularly, and surprisingly, there is nothing in the Bill on reducing harm from tobacco products and alcohol, which is why I rise to speak in support of new clauses 2 to 4, which seek to strengthen the health warnings on all tobacco products; new clauses 7 to 10, which seek to allow regulation of tobacco pricing; and particularly new clause 6, because the use of sweet flavourings to entice children and young people to take up smoking is indefensible.

Barry Gardiner: I heartily commend the hon. Lady for her comments. Does she experience in her constituency, as I do in mine, that smoking cessation services are diminishing and becoming less successful? As the tobacco  industry concentrates on a core group of existing addicts, it is desperate to move down the age range and encourage new addicts. That is why that element of the new clause is important.

Philippa Whitford: I agree that new clause 6 is the most important of the new clauses, because tobacco companies are driven to recruit new victims—as I would have to call them, as a doctor—and they are recruiting them from young people.
Public health is devolved, so we have not had the cuts in public health funding that we have unfortunately seen in England since 2016. Therefore, we have not had the cuts to smoking cessation and sexual health services that many local authorities experienced across England when public health moved into local government.
Smoking does not just cause respiratory problems such as chronic obstructive airway disease, but affects all the blood vessels causing peripheral vascular disease, vascular dementia, strokes, heart attacks and many forms of cancer, not just lung cancer. Stopping smoking is the best favour anyone can do themselves, but many people require the very smoking cessation services that the hon. Gentleman mentioned.
I find it surprising that there was nothing in this Bill about tackling not just the health harms, but the social harms associated with alcohol abuse. Indeed, alcohol has not even been included in the definition of less healthy foods, despite that clearly being the case. There is no health argument for alcohol. I am not saying that people have to abstain, but the research many people cite about how having some alcohol is of health benefit over full abstention has all been discredited. That was because people who actually had alcoholic disease and were made to give up alcohol were put in the abstention group, and therefore brought their liver disease, their varices and everything else with them. More recent research shows that, unfortunately, alcohol does cause harm. It is only about 10 or 15 years since we learned about its association with breast cancer, my specialty as a surgeon, and with that it is absolutely the case that the more alcohol a woman drinks, the higher her risk of breast cancer.

Christian Wakeford: Obviously, as the chairman of the all-party parliamentary group on alcohol harm, I know that part of the issue with treatment—I am thinking in particular of new clause 16—is the stigma behind alcohol dependency and its still being seen as a personal choice. While we need to overcome the stigma of addiction, we first need to be having a conversation about alcohol. Does the hon. Member agree that, as part of the treatment, we need to be having this conversation on a national level?

Philippa Whitford: I would say that really no one who has a health problem should be stigmatised. Having dealt over 33 years in the NHS with many people who were problem drinkers, I know that the public image of someone who abuses alcohol is quite a caricature. There will be many people across this House who drink more than is healthy for them and I have met many people as patients from the middle and upper classes who had serious alcohol problems, so we should get  away from the stigma and the caricature. We will not spot everyone who needs to deal with alcohol just by looking at them.

Catherine West: I commend the work of my hon. Friend the Member for Liverpool, Walton (Dan Carden) in this regard. Does the hon. Lady agree with me that the whys and wherefores are all very well in this debate, but in the end the cuts to local government, which would primarily be providing services in relation to alcohol abuse, have been most disgraceful, and that is why we are seeing the huge increase in the number of people who have passed away from alcohol disease in the last couple of years following covid?

Philippa Whitford: There is no question but that, after public health moved into local government—we can absolutely defend that because, as I have said, health is often delivered by things that are nothing to do with the NHS—the problem was that the budget was then cut, so the potential benefit of putting public health into local government was lost due to the cuts to services.
On alcohol not being classed as a less healthy food, with this Government I find it hard not to ask: why not, and what or who may have influenced that decision? I certainly support amendments 11 to 13 from the hon. Member for Liverpool, Walton (Dan Carden), which would include alcohol, particularly the medium and high-strength alcohols, under less healthy foods, so that alcohol is covered by advertising regulations. I also support his new clause 15, which would mandate much clearer labelling of alcohol units, or whatever measure, on labels. It is no good just saying “Drink aware” or “Drink Responsibly” when the consumer has not actually been given the tools on the product to make a proper choice, such as by asking, “How much is in this?” Why not agree to use a simple, straightforward approach? A lot of public health advice is in units, so why not actually use them? People would then learn to be aware and ask, “How many units have I already drunk today?” or “How many units have I already drunk this week?”
New clause 17 calls on the UK Government to follow Scotland, and now Wales, by introducing a minimum unit price for alcohol. The UK Government have the advantage in that they can do that by setting alcohol duty based on unit, instead of on classes of drink. In every Budget we hear about a penny on a pint of beer, or so much on spirits, but why not do it by unit? It is much more accurate, and it would still allow the raising of taxation to help fund alcohol services, as well as those public services most hit by alcohol abuse, such as healthcare and policing. Under devolution the Scottish Government, and now the Welsh Government, did not have that power.
Over the past year and a half of the pandemic we have, unfortunately, seen a big increase in both smoking and alcohol consumption, as people struggled to cope with the loneliness and boredom associated with lockdowns and pandemic restrictions. However, the initial valuation of minimum unit pricing in Scotland showed that alcohol sales fell, for the first time in many years, by more than 7% in Scotland, compared with a continued rise in England and Wales. It was not possible to demonstrate a reduction in overall alcohol-associated admissions  to hospital, which may include car accidents, violence  and so on, but there was a drop in admissions due to alcoholic liver disease, suggesting that the policy was  working. More evaluation after the pandemic will be required, but an immediate impact was an almost three-quarters drop in the sales of cheap white cider. That product is cheaper than soft drinks, and predominantly used by young—indeed, often under-age—drinkers, who purchase it, or get someone else to purchase it, so that they can drink it at home. However, that sector is literally disappearing overnight.
It will be important to review and maintain the pressure of the unit price on a regular basis, because young drinkers also drink many other products—this is the same issue as young smokers; more people are being recruited, often into problem drinking and problem products. Minimum unit pricing does not affect good wine, high-end spirits, or what is sold in a pub, but it does affect what someone can buy in a small shop to then hang out with their mates in their bedroom. Some of those products are not affected by the 50p unit price, and that must be kept under review.
I was disappointed that new clause 30, which is listed for discussion tomorrow, was not included in this group. It calls on the Government to reform the out-of-date Misuse of Drugs Act 1971, and to devolve it so to allow the devolved nations to take a public health approach to tackling drug addiction, in the same way as we take a public health approach to dealing with alcohol. Such an approach has already been demonstrated in many countries across the world, yet the Government keep sticking their head in the sand.

Hywel Williams: I am grateful to the hon. Lady for mentioning new clause 30, which I still hope against hope we might be able to discuss tomorrow. I am sure she will agree that problematic drug abuse is an illness and a social ill, not a crime, and our emphasis must be on harm reduction, treatment, and support for the problematic drug user.

Philippa Whitford: That is the policy of the Scottish Government, and we would absolutely support the new clause if it is voted on tomorrow.
As Opposition Members have said, key to improving public health would be restoring the non-covid related public health budget in England. We cannot hide behind covid funding, because that is used up by the pandemic and does not help us with smoking, alcohol, or drug addiction. The biggest contribution the Government could make would be to abandon their plans for yet another decade of austerity. We hear the slogan all the time—levelling up—but it rings hollow after taking away £1,000 a year from the poorest families and most vulnerable households. Over the past decade, cuts to social security have caused a rise in poverty among pensioners, disabled people, and particularly children. Sir Michael Marmot was mentioned earlier, and his research was clear: poverty is the biggest single driver of ill health, and the biggest driver of poverty is Tory austerity.

Bob Blackman: It is a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford), who brings her knowledge of the medical profession to this House on every occasion. I agreed with almost everything she had to say, apart from the last comment.
I declare my interest as chair of the all-party group on smoking and health, and I support all the new clauses tabled in the name of the hon. Member for City of Durham (Mary Kelly Foy). These comprehensive proposals are complementary and can be picked up by the Government. The new clauses were tabled in a different form in Committee. They were discussed and debated, and I think Ministers said they would take them away and have a further look. We have refined the proposals on the basis of the debate in Committee, strengthened them, and brought them back again, and they address the loopholes in current legislation. They strengthen the regulation of tobacco products still further, and they provide funding for the tobacco control measures that are so desperately needed if we are to deliver the Government’s Smokefree 2030 ambition.
We had an excellent debate in Westminster Hall last week, to which the new Under-Secretary of State for Health and Social Care (Maggie Throup) responded. Questions were posed to the Government from across the Chamber about when we will see the long-promised tobacco control plan, which is presumably due to be delivered by 31 December this year. We got no firm commitment on when we will see it, and I would like my hon. Friend the Minister to bring that forward as soon as possible. We can then measure what will happen.
The problem we have with tobacco control right now is that if we do nothing and none of these measures is introduced, the risk is that, as the hon. Member for City of Durham rightly articulated, we will miss the target by seven years. For those on low incomes and in deprived circumstances, it will be 14 years. We must consider how many people will die from smoking-related diseases as a direct result of the Government’s failure to achieve their Smokefree 2030 ambition. It is clear that we need to take further action, and I urge the Minister, who I know is a doughty campaigner for public health, to make sure that we deliver on the proposals.
My main focus is obviously on the new clauses that seek to provide funding for tobacco control. We all accept that not only can we implement measures, but we have somehow to fund them. That is critical. We must also consider raising the age of sale, as that, unfortunately, is a key proponent in encouraging young people to start smoking. The spending review failed to address the 25% real-terms cut to public health funding since 2015. Reductions in spending on tobacco control have bitten even deeper, by a third, since 2015. We need new sources of funding.
The Government promised to consider a polluter pays levy in the 2019 Prevention Green Paper, when they announced the Smokefree 2030 ambition. The all-party group on smoking and health has done the analysis, and we estimate that in the first year alone of a polluter pays levy, £700 million could be raised. That would benefit not only England, but the whole United Kingdom. It is more than twice the estimated cost of the tobacco control measures that we are proposing tonight, and that would then leave the Government with further funding to spend on other health priorities. The proposal is for a user fee, along United States lines, rather than an additional tax. Now that we have exited the European Union and can set our own rules, EU tobacco manufacturers’ profits can be controlled. They cannot pass the cost on to the consumer, but we can control their profits and use those for preventing people from smoking in the first place. It is quite justified that  we should tax the manufacturers’ profits. This is the most highly addictive product that is legally available, and it kills those who use it for the purpose for which it was intended.

Peter Dowd: The hon. Gentleman refers to public health funding since 2015, but is he aware that in 2015, it was identified that the cost to the NHS of smoking was £144.8 million in prescriptions, almost £900 million in out-patient visits, almost £900 million in hospital admissions, and a total of £2.6 billion? Is not investing in smoking cessation money well spent?

Bob Blackman: Clearly, if we invest in public health and smoking cessation, we prevent costs in the health service later. It is estimated that most of the cost of people’s healthcare arises in the last two years of their life. Individuals who suffer from cancer or other respiratory diseases caused by smoking will cost the health service dramatic sums of money, so through cessation, we are helping the nation to be healthier and, indeed, saving money for the health service in the long run.
To quote the chief medical officer, the great majority of people who die from lung cancer
“die so that a small number of companies can make profits from the people who they have addicted in young ages, and then keep addicted to something which they know will kill them.”
The time has come to make the tobacco manufacturers pay for the damage that they do, not only to older people but to young people in particular. We need to bring forward the day when smoking is finally obsolete in this country, and I regret to say that if we do not take measures, the time before that day arrives will be lengthened quite considerably.
However, funding alone is not enough; we have to consider tough regulation. The hon. Member for Central Ayrshire mentioned that since lockdown, we have seen the smoking rate among young adults surge by 25%. In the United States, raising the age of sale from 18 to 21 reduced the smoking rate among 18 to 20-year-olds by 30%. We could do the same thing here. We talk about complementary measures; giving tobacco products away is not illegal at the moment. Just imagine—tobacco manufacturers may say, “If we give tobacco products away for free, we can encourage people to become addicted, and then they will buy them, and that will lead them on to a lifetime of smoking.” We have to break that chain of events and make sure that people do not do that.
I have a passion for ensuring that women do not smoke in pregnancy. That is one of the most stubborn measures, and we have to overcome it. Some 11% of women still smoke in pregnancy. We must give them every incentive and introduce every measure to ensure that they give up smoking, and that their partners give up smoking at the same time. That is something that I passionately support.
Our revised amendment, new clause 11, addresses the concerns that the Government raised in Committee about a review of the evidence. I hope that the Government will adopt the new clause at this stage, and then look at the evidence and consult.
People start smoking at certain key points in their life. They may take it up when they are at school and their friends are smokers and they want to be part of  the team or the gang. They may take it up when they go to college or university or start a new job, when they are in a new social environment, or at a dreadful time of stress in their life. We have to make sure that they understand that if they take up smoking, they will shorten their life and cause damage to their health—and, indeed, to the health of the people around them.

Oliver Heald: I am following my hon. Friend’s argument closely. Does he agree that there is an interrelationship between the issues to do with alcohol dependency that the hon. Member for Central Ayrshire (Dr Whitford) mentioned and the issue of smoking? One of the things that comes out from the book “Alcohol Reconsidered” by Lesley Miller and Catheryn Kell-Clarke is that the science shows that alcohol reduces people’s inhibitions, and it is therefore more likely that they will smoke. If we had a culture of moderation in alcohol, we would probably do better on smoking.

Bob Blackman: I thank my right hon. and learned Friend for raising that point. Clearly, the fact that people can no longer smoke in public houses or restaurants has dramatically reduced the incidence of smoking. Someone has to make a deliberate decision to go outside and inflict their smoke on the outside world rather than on the people in the public house or restaurant.
We who support these amendments tabled them in Committee—we sought Government support and we debated them in Committee—and now we are debating them on Report. I understand that we may not be successful tonight, but I give fair warning that these amendments, in another form, will be tabled in the other place, and we will see what happens. We know that there is very strong support in the other place for anti-tobacco legislation. In July 2021, the Lords passed by 254 votes to 224 a motion to regret that the Government had failed to make it a requirement that smoke-free pavement licences must be 100% smoke free. That is smoking in the open air; we are talking about measures to combat smoking overall.
Finally, if we look back over the years, the measures on smoking in public places, on smoking in vehicles, on smoking when children are present and on standardised packaging of tobacco products were all led from the Back Benches. Governments of all persuasions resisted them, for various reasons. I suspect that my hon. Friend the Minister, whom I know well, may resist these measures tonight, but we on the Back Benches who are determined to improve the health of this country will continue to press on with them, and we will win eventually. It may not be tonight, but those measures will come soon. I support the measures that are proposed.

Geraint Davies: It is a great pleasure to follow the hon. Member for Harrow East (Bob Blackman), who gave an eloquent speech about smoking. What he did not include, and what the Minister is not considering, is the mass passive smoking from air pollution, which causes 64,000 deaths a year. I know that I am in danger of being outside the scope of the Bill, but I will make this point just briefly, because it is about public health.
Indoor and outdoor air pollution is endemic. It costs £20 billion a year. We could simply ban wood-burning stoves, which 2.5 million people have and which contribute 38% of the PM2.5 emissions in our atmosphere. That is  particularly problematic in poorer areas. I make this point partly as I chair the all-party parliamentary group on air pollution, but this is a critical public health issue, so I feel that the Department of Health and Social Care should look at it centrally, rather than leaving it to the Department for Environment, Food and Rural Affairs as an air quality issue.
I turn to the comments by the hon. Member for North East Bedfordshire (Richard Fuller), who sadly is not in his place, about free choice in advertising. Advertising is not about free choice; one would not need to advertise unless one was trying to convince somebody to do something they would not otherwise do. That is not to say that advertising is always bad—good things and bad things can be advertised—but let us be straightforward.
As it happens, I have a background in multinational marketing; I have been involved with PG Tips and Colgate toothpaste—good products. However, the reality is that if someone wanted to make money from a product such as a potato, which is intrinsically good for people, they could impregnate it with salt, sugar and fat, make it into the shape of a dinosaur, get a jingle and call it “Dennis’s Dinosaurs”, and make a lot of money out of that simple potato. That is the way a lot of processed foods work.
Going back to the point about diabetes and added sugar, it is important to remember that diabetes in Britain costs something like £10 billion a year. There is a compelling case for the Government to do more about added sugar, as opposed to natural sugar; obviously, we could discriminate between the two, though a lot of manufacturers will say, “Are you going to tax an apple?”. Clearly, when a child or adult can find a huge bar of chocolate in a shop for £1, we have problems, in terms of the amount of sugar we are supposed to have. Henry Dimbleby put forward a national food strategy, which is worth a read. He makes the key point that reducing the overall amount of money people have—for instance, through universal credit—has a major impact: we find that when universal credit goes down, consumption of alcohol and smoking go up.
It is important for the Department of Health and Social Care to have an idea of how the nutrition of particular natural foods can be increased through better farming. An app will be available next year that will enable people to test a carrot in their local shop. The carrot will have different levels of antioxidant, depending on how it is grown. If it is organic and not impregnated with all sorts of fertiliser and chemicals, it develops a natural resistance to pesticides and is much better for human health. The Government should, in this post-Brexit world, be actively encouraging local high-value, high-nutrition products for export and local consumption.
A whole range of public health measures that need to be moved forward are not in the strategy; but some are, such as those raised by the hon. Member for Harrow East.

Nigel Evans: I call Christian Wakeford. Do you wish to remain seated?

Christian Wakeford: That is greatly appreciated, Mr Deputy Speaker.
I would like to put on record my support for amendments 11, 12 and 13, and new clauses 15 and 16. I also thank the hon. Member for Liverpool, Walton (Dan Carden). We have heard why he cannot be here; I wish him well with what is going on in his family.
These much-needed amendments and new clauses are aimed at reducing alcohol harm by introducing advertising restrictions, transparent alcohol labelling and support for effective alcohol treatment. Alcohol abuse leads to many harmful things, and deserves to be called the silent killer. I am chair of the all-party parliamentary group on alcohol harm, and the group has heard in our evidence sessions the stories of those affected by alcohol. It has the potential to destroy individuals, families and wider society. Alcohol has a very public face, but it harms privately. Hospital admissions and deaths from alcohol are at record levels, and have been exacerbated by the covid-19 pandemic. Some 70 people die every day in the UK due to alcohol. Alcohol harm is a hidden health crisis that needs to be recognised.
The Bill does not go far enough to stem the rising tide of this issue. For instance, the Bill introduces restrictions on advertising for “less healthy” products, such as sugary soft drinks, but the same restrictions do not apply to adverts for alcoholic drinks, despite alcohol being linked to more than 200 health conditions, as well as having very high calorie and sugar content. There is significant evidence that children who are exposed to alcohol marketing will drink more earlier than they otherwise would. Existing laws are failing to protect children and vulnerable people. In fact, four in five 11 to 17-year-olds have seen alcohol advertising in the past month. The advertising they are exposed to builds alcoholic brand awareness and influences their perceptions of alcohol. A forthcoming report by Alcohol Health Alliance found that seven  in 10 young people recognise the beer brand Guinness, including more than half of 11 to 12-year-olds. Amendments 11 to 13 would ensure that alcohol was considered a less healthy product and was therefore liable to the same proposed restrictions as sugary soft drinks when it comes to advertising on TV, on demand and online.
Awareness of the risks of alcohol is low: about 80% of people do not know the chief medical officer’s low-risk drinking guidelines of 14 units a week; only 25% are aware that alcohol can cause breast cancer; and only 20% know the calories in a large glass of wine. I need only refer you, Mr Deputy Speaker, to the Six Nations championship earlier this year—you may have a slightly better recollection of it than I do. There was alcohol-related advertising on billboards around the stadiums. There were many billboards advertising alcoholic brands. There were also drink awareness campaigns, but they were not seen, due to where those advertisements were placed. People were seeing adverts for Guinness, but not for Guinness 0.0 or for drink awareness campaigns. This is something that the Government really need to look into.
New clause 15 requires the Secretary of State to introduce secondary legislation on alcohol product labelling. Consumers have a right to know what is in their drinks to make informed choices about hat and how much they drink. However, there are currently no legal requirements for alcohol products to include health warnings, drinking guidelines, calorie information or even ingredients. Research by Alcohol Heath Alliance found that over 70% of  products did not include the low-risk drinking guidelines and only 7% displayed full nutritional information, including calories. The Government's forthcoming consultation on alcohol calorie labelling is welcome. However, more needs to be done to ensure other health information is provided on labels. Many companies are already looking at e-labelling, so that anyone with a smartphone can access the information online. That is a very welcome step, but we need to do more.
Lastly, alcohol treatment services are essential to support recovery for those with alcohol dependence. Pre-pandemic, only one in five dependent drinkers was believed to be in treatment, leaving a shocking 80% lacking help. My own brother was one of those. Unfortunately, six years ago I lost him to alcohol dependency, which is why I take this matter incredibly seriously. New clause 16 requires the Secretary of State to report on the ability of alcohol treatment providers to offer support and reduce alcohol harm, and on the levels of funding required. Low levels of access to alcohol treatment are largely due to insufficient funding. Since 2012, there have been real-terms funding cuts of over £100 million—an average of 30% per service in England. Alcohol treatment is cost-effective: every £1 invested in alcohol treatment yields £3 in return, rising to £26 over 10 years. Recovery also yields powerful dividends for families affected by addiction.
In conclusion, the Bill needs to go further than it currently does to include evidence-based measures that reduce alcohol harm. I encourage Members across the House to support these much-needed amendments, so that we can tackle this silent health crisis affecting so many of our constituents.

John Stevenson: I rise to support the amendments in my name: 110, 111, 112 and 113. I draw the attention of the House to the fact that I have a significant number of food and drink manufacturers in my constituency, and that I chair the all-party parliamentary group for food and drink manufacturing. I also support the amendments tabled by my hon. Friends the Members for North East Bedfordshire (Richard Fuller) and for Buckingham (Greg Smith), and fully support and endorse their comments.
In reality, I and many others would have preferred clause 125 and the whole of schedule 16 to have been removed from the Bill. I and I think many others are not convinced that that is really the way forward or that it will achieve very much. That view is shared by many of my colleagues, but also by many in the advertising industry and the food and drink sector. That is not because they are against the Government’s attempts to respond to the challenge of obesity, which is and should be a concern for all of us, but because their impact is likely to be so insignificant that it is disproportionate to what is proposed. We should also remember that the industry has already done a huge amount. It is incredibly innovative—reformulation, reductions in salt and sugar—and the reductions we have already seen are very significant. The industry continues to make changes and I believe it will continue to do so in the future. We should also remember that there is something called personal responsibility.
There is an opportunity, however, for compromise and improvements to schedule 16—hence the various amendments that have been tabled. I very much hope  that the Government will be willing to compromise in their approach and see the benefits of the amendments that stand in my hon. Friends’ names and mine. I do not intend to detain the House for long, because my amendments are primarily technical rather than anything greater.
I tabled amendments 111, 112 and 113 because I believe that we want a food and drink manufacturing sector that is competitive and is based in the UK as much as possible. As presently drafted, the Bill exempts certain businesses, but the criteria are based on UK employee numbers. Large multinational companies could therefore be exempt if the UK element of their business has under 250 employees; conversely, a UK business with 250-plus employees would not be exempt. That has the potential to be unfair in many respects to UK businesses from a competition perspective, and could lead them to divert manufacturing abroad. A simple solution would be to take account of turnover as well as staff numbers. I have suggested using the definition in section 465 of the Companies Act 2006, which I believe would deal with the situation.
Under the Bill, paid-for branded adverts for products that are high in fat, salt or sugar would be prevented on retailer-owned spaces, but retailers would still be able to advertise equivalent HFSS own-brand products. That could distort competition directly between retailers’ and manufacturers’ products. Amendment 110 would ensure a level playing field, which in my view would be much fairer.
I hope that the Government will be receptive to my amendments—if not now, via changes introduced in the other place. In anticipation of such a compromise, I do not intend to put them to the vote.

Edward Argar: I am grateful for this evening’s debate. More than once during the passage of the Bill, I have put on the record the Government’s commitment to improving and protecting the public’s health and have paid tribute to the hard work and dedication of our NHS and public health professionals in rising to the greatest infectious disease challenge of modern times. I would again like to put on the record those important points, with which I know Opposition Front Benchers agree.
Our commitment to public health is clear in the Bill, in the proposals set out in the Government’s recently published plan for health and care, “Build Back Better”, and in our wider programme of public health reform. A focus on the prevention of avoidable diseases is a central principle in delivering a sustainable NHS and in levelling up health outcomes across the country.
Childhood obesity is one of the biggest health challenges that this nation faces. The latest data from the national childhood measurement programme revealed that approximately 40% of children leaving primary school in England were overweight or living with obesity.

Catherine West: The Minister is being generous in allowing interventions. Is the Bill silent on the challenge around prescriptions for exercise? In an earlier intervention, I mentioned the impact of school swimming. Unfortunately, we are going backwards: fewer 11-year-olds can swim 25 metres—that is just an example. On childhood obesity, we need to address both: not just diet, but exercise.

Edward Argar: I am grateful to the hon. Lady, with whom I worked in London local government many moons ago on issues not dissimilar to those that we are debating. The Bill focuses on diet and the obesity that it causes, but she is right to highlight that exercise and a healthy lifestyle also play a key role in tackling obesity. We do not believe that the Bill is the right place to put that role into legislation, but I join in the sentiment underpinning what the hon. Lady says. Schools, local authorities and health bodies need to consider the issue in the round.
Nearly two thirds of adults—64%—are also overweight or living with obesity. I am grateful to my hon. Friend the Member for North East Bedfordshire (Richard Fuller) for gently tempting me to respond to his points about the nanny state, but I would argue that it is not being a nanny state to look out for the health of our citizens. Yes, it is about giving advice and giving people the information to make informed judgments, but it is also about putting in place a proportionate framework in legislation.
As with the speech of my hon. Friend the Member for Harrow East (Bob Blackman), I did not agree with everything that the hon. Member for Central Ayrshire (Dr Whitford) said, particularly her concluding comments, but I listened carefully to her comments about seatbelts. She said that she, as a clinician, saw the impact that legislation on that public health and public safety measure had on reducing injuries.

John Stevenson: Does the Minister agree that the industry itself is doing an awful lot now to support the Government’s agenda? Does he also acknowledge that personal responsibility is very important?

Edward Argar: I wondered what I was about to have bowled at me there, but my hon. Friend is absolutely right. I entirely agree that a huge amount of progress has been made; we believe that we need to go further with our proposals, but he is right to highlight that progress. He is also right to highlight the relevance of the central role of personal responsibility and the decisions that we and our families all take.
To meet the ambition of halving childhood obesity by 2030, it is imperative that we reduce children’s exposure to less healthy food and drink product advertising on TV and online. We want to ensure that the media our children engage with the most promote a healthy diet. The Bill therefore contains provisions to restrict the advertising of less healthy food and drink products on TV, in on-demand programme services and online.

Richard Fuller: The Minister has just mentioned seatbelts, and earlier he talked about alcohol and cigarette smoking, but this is about porridge and muesli. There is a sense that there is no end to what the Department of Health and Social Care feels is its responsibility to legislate on for what people should be able to do for themselves and their family. My point is that this is overreach by the state, as well as perhaps being the incorrect process for achieving the Government’s aims.

Edward Argar: I know my hon. Friend well and entirely understand the perspective that he brings, but I would argue as a counterpoint that the Bill strikes a proportionate balance, in the same vein as with seatbelts  and other issues. Alongside personal choice and giving people the information to make choices, I believe that it is a proportionate and balanced approach—not the thin end of the wedge, as he might suggest, although perhaps I am characterising his words unfairly.

Julian Lewis: Will the Minister give way?

Edward Argar: May I make a little more progress? I have more to say on obesity, so my right hon. Friend should not worry.
We held two consultations, the first in 2019 and the second in 2020, which have informed our policy on introducing further restrictions to the advertising of less healthy food and drink products. I welcome the devolved Administrations’ engagement and support for the policy, which is being brought forward UK-wide. The UK Government have engaged with them extensively on the matter since early 2021; I put on the record my gratitude for the spirit in which they have approached it.

Julian Lewis: I happen to agree that there is a question of proportionality on the alleged nanny state issues, but does my hon. Friend agree that where an issue is contentious—such as the fluoridation of water supplies, which has been contentious over many years in this House—it should be properly debated before the state takes control of it, not just tucked away at the end of a very long Bill? That causes me concern.

Edward Argar: I take my right hon. Friend’s point, but I would argue that we are placing the matter before the House in a Bill that has been debated and has gone through its stages, including one of the longest Committee stages of a Bill in my time in this House. There is, or was, the opportunity for Members to table amendments on Report on the aspect that he mentions, and I suspect that it will be extensively debated in the other place as well. I take his point, but I would argue that we have provided sufficient time and have brought the issue to the House in that way.

Julian Lewis: Would the Minister be as surprised as I was to know that quite a lot of Members of this House are completely unaware that that provision has been added at the end of the Bill?

Edward Argar: All I would say—without in any way implying any criticism of right hon. or hon. Members—is that soon after I entered the House I was a member of the Procedure Committee for a year, and one of the first pieces of advice I was given was to read the legislation and go through it in its entirety. I recognise that this is a long and complex piece of legislation, but I would make that point.
Telecommunications and internet services are reserved matters. The UK Government are clear about the fact that the primary purpose of provisions on the advertising of less-healthy food and drink for TV and internet services is to regulate content on reserved media, and on that basis the policy is reserved. The purpose is not incidental. Therefore, the provisions do not fall within the competence of the devolved legislatures or engage the legislative consent process. While the Scottish and Welsh Governments have agreed with our policy ambitions, they disagree with our legal assessment, and thus far we have had to agree to disagree on this matter, but we have  had extensive engagement, and I suspect that we will continue to do so. I see that the hon. Member for Central Ayrshire is in her place, and while she is present I would like to thank both Governments for their engagement and offer my assurances that it will continue as we implement the policy for the benefit of citizens across the UK.
I am grateful to my hon. Friend the Member for North East Bedfordshire for his amendments 6 to 8, which would require the Secretary of State to conduct a public consultation before any changes could be made to the relevant guidance, the nutrient profiling model, in which I know the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), takes a particular interest. The principle and importance of the amendments is recognised, but we fear that, as drafted, they may create a number of unintended consequences. When consultation exercises need to reach a diverse audience, several approaches may be appropriate. For example, words such as “public” may be interpreted in a number of ways in different contexts, and would risk rendering the legislation insufficiently clear. However, as I confirmed in Committee, the Government have now tabled their own amendments to ensure that a requirement for the Secretary of State to consult before making any changes to the relevant guidance appears in the Bill.
Let me now turn to amendments 31, 33, 34, 36, 38 and 39, tabled in the name of my right hon. Friend the Secretary of State. These new amendments to schedule 16 will insert a requirement for the Secretary of State to consult persons whom he or she considers relevant before any changes can be made to the use of the technical guidance known as the nutrient profile model. This applies to the restrictions on less-healthy food and drink advertising outlined in the Communications Act 2003. An amendment has been made to each of the TV, on-demand programming services and online sections, ensuring that all parts of the policy are covered by this new duty to consult before changing the NPM.
The less-healthy food and drink advertising restrictions outlined in schedule 16 use a two-step approach to determine whether a product is “less healthy” and therefore within the scope of the policy. First the products need to fall into one of the categories identified as significant contributors to childhood obesity; then the product needs to be classed as “less healthy” in accordance with the relevant guidance. That guidance is the Nutrient Profiling Technical Guidance of January 2011, which sets out the requirements of the existing nutrient profiling model of 2004-05. The Secretary of State has the power to make regulations to change the meaning of “the relevant guidance” in the future, for example if the guidance needs to be materially modified to reflect changes in nutritional advice on what constitutes “more” or “less” healthy or an alternative model is developed.
This power is subject to the affirmative procedure, ensuring that there will be clear parliamentary scrutiny at the point at which any changes are brought forward.
Although, as Members may know, over the past few years work has been under way to update the NPM in line with updated dietary recommendations, it is not our current intention to apply it to the less-healthy food and drink advertising restrictions policy that the House  is now debating. We made it clear throughout the 2019 and 2020 consultations that if we wanted to use the updated NPM in the future, we would first need to consult and invite views from interested stakeholders.
I appreciate the concerns that Members have raised, and would like to reassure them, the House and, indeed, industry. These technical amendments will not change the policy intent of the original provisions. I hope  that they will address the valid concerns that my hon. Friend the Member for North East Bedfordshire has understandably raised today, and I hope that he and colleagues across the House will be able to support them in place of his amendments.

John Hayes: It was my hon. Friend the Member for North East Bedfordshire who inspired my intervention. I just want the Government to make it clear that they are not contributing to a strange paradox which seems to prevail in modern society, that of being simultaneously more puritanical and more prurient. We are prurient in that we let the tech giants corrupt our children in all kinds of ways, and puritanical in that we are censorious about the jokes people tell, the language they use, and how much ice cream—or indeed Christmas cake—they eat.

Edward Argar: I am grateful to my right hon. Friend. It has been a while since he intervened while I was at the Dispatch Box, so this has been a pleasure. I have never seen him as in any way a puritan; I suspect that he is rather more a cavalier in his approach to life.
My hon. Friend the Member for North East Bedfordshire has also tabled amendments to schedule 16 which would insert in the Bill an exemption from the advertising restrictions for brand advertising. I am grateful to him, but I can reassure him that the Bill already delivers that exemption, and I therefore believe that his amendments are not necessary to achieve the effect that he seeks. We made that clear in the consultation response published in June this year, and in speeches made in Committee.
My hon. Friend has also tabled new clause 14. As I am sure he and other Members are aware, the Government consulted on different approaches for restricting online advertising in 2019, and considered alternatives submitted through the consultation process. However, it was felt that the alternatives, including the proposal from the Committee of Advertising Practice to use a self-regulatory mechanism based on targeting, were sufficiently similar to the policy options previously consulted on. These were not sufficient to meet the objective of the policy, namely to protect children from advertisements for less-healthy food and drink.

Alun Cairns: Does the Minister accept that there is a significant inconsistency between the approach to television broadcasters and the approach to those who use social media and online provision, and that a consistent approach would help? Does he also accept that a considerable array of views has been expressed by those seeking to help him to develop the Bill in a positive way, and will he maintain an open mind as it passes through the other place to establish whether it can be refined to achieve some of these objectives?

Edward Argar: I hope I can reassure my right hon. Friend, and other Members, that I always seek to maintain an open mind, and always seek to reflect carefully on  the contributions made by Members. I will turn shortly to the challenges posed by television, which is essentially a linear broadcasting medium, in comparison with those posed by online broadcasting. I am conscious that I must conclude my speech before 7 pm.
There is evidence to suggest that the targeting of online adverts does not account for the use of shared devices and profiles between parents and children, the communal viewing of content or false reporting of children’s ages. This, combined with concerns about the accuracy of interest-based targeting and other behavioural data as a way of guessing a user’s age and a lack of transparency and reporting data online, shows why the Government believe that we need to introduce strong advertising restrictions online. Any alternative proposals would therefore need to meet a high bar in terms of protecting children online, and we consider alternatives that rely on a targeting approach to be—currently—potentially insufficient to meet the policy objectives.
Amendments 106 to 109 are relevant to the point that my right hon. Friend has just made. I am grateful to my hon. Friend the Member for Buckingham (Greg Smith) for raising these matters. His amendments mean that liability for online advertisements found to be in breach of the restrictions included in the Bill would shift to become the responsibility of the platforms rather than the advertisers, which some may see as providing parity with the enforcement mechanisms for broadcast television.
During the 2020 consultation, we considered whether other actors in the online advertising sphere should have responsibility for breaches, alongside those of advertisers. However, we concluded that this was not the right place to consider that broader issue.
The online advertising ecosystem is complex and dynamic. The scale and speed of advertising online, as well as the personalised nature of advertising and the lack of transparency in this system, makes it difficult for platforms to have control over what is placed on them. The approach that we are taking in the Bill best aligns with the current enforcement frameworks across TV, online and on-demand programme services advertising, and is familiar to industry. It will ensure that there is limited confusion for broadcasters, platforms or advertisers, as the liable parties for less-healthy food and drink product advertising breaches will be the same as those for any other advertising breaches. The Government intend to consider this issue as part of the wider online advertising programme, on which the Department for Digital, Culture, Media and Sport will consult in the coming months.

Greg Smith: I am grateful to the Minister for that commitment to consider the points in my amendments, and with that commitment in place, I will not seek to push them to vote. However, may I ask him, as he makes these considerations along with colleagues in the DCMS, to ensure that broadcasters are fully consulted so that they can point out the loopholes that any online provisions could throw up?

Edward Argar: I am grateful for my hon. Friend’s confirmation that he does not intend to press his amendments to a Division, and I will ensure that his point will be heard not only in the Department of Health and Social Care but in DCMS as well.
I am grateful to my hon. Friend the Member for Carlisle (John Stevenson) for his amendments 111 to 113 and for bringing this debate before the House. I would like to reassure him that small and medium-sized enterprises—businesses with 249 employees or fewer—that pay to advertise less healthy food and drink products that they manufacture and/or sell will be exempt from the less healthy food and drink restrictions and can continue to advertise. The definition of SMEs will be provided in secondary legislation and not on the face of the Bill, which will enable Ministers to act promptly in future years if new or emerging evidence suggests that amendments are needed. We will conduct a short consultation as soon as possible on the SME definition to be included in the draft regulations. The Government want to ensure consistency with other definitions for size of business that have been used for other obesity policies, such as the out-of-home calorie labelling policy, to create a level playing field. Our preferred definition, therefore, is a standard definition used by Government across other policies.

Richard Fuller: On the point about an industry-led alternative, on which the Minister has kindly made some comments today, I think that this discussion will continue, particularly when the Bill is considered in the other place, so would he be prepared to meet me so that I can continue to make representations about certain improvements that could be made?

Edward Argar: I am certainly happy to commit that either I, as the Bill Minister, or the relevant policy Minister will meet my hon. Friend to discuss his views in this space.
Amendment 110 would ensure that advertisements placed on distributor or retailer websites are out of scope of the less healthy food and drink advertising restrictions. Again, I am grateful to my hon. Friend the Member for Carlisle for tabling the amendment, and I would seek to reassure him that the Government’s intention is to ensure that restrictions are proportionate to the scale of the problem. It is not our intention to prohibit the sale of less healthy food and drink products on the internet. Our aim is to reduce children’s exposure to advertisements of less healthy food and drink products, which is why the restrictions are being applied only to paid-for advertising online—namely, where an advertiser pays by monetary or other reciprocal means for the placement of adverts online.
We appreciate that there will be consumers who seek less healthy food and drink products, which is why this restriction applies only to paid-for advertising, and companies will be able to continue to use owned media in the same way as they do now. The restrictions will not apply to spaces online where full editorial control and ownership apply, such as a brand’s own blog, website or social media page. This means that retailers are able to continue promoting their own products on their own website, as this would not be covered by the restrictions.
I shall turn briefly to Government amendments 32, 35 and 37, tabled in the name of the Secretary of State for Health and Social Care. Amendments 32 and 35 will amend the definition of an advertisement placed on television and on-demand programme services to ensure that sponsorship credits around programmes and sponsorship announcements respectively are included for the purpose of this Bill. Members will be aware that  sponsorship announcements and sponsorship credits are required so that viewers know which product is sponsoring any particular programme. Although these are not routinely considered to be advertisements in other contexts, the Government’s view is that they could reasonably be considered to be advertising less healthy food and drink products for the purposes of the Bill’s restrictions.
Amendments 32 and 35 will therefore clarify the status of those announcements, in effect to prohibit identifiable less healthy food and drink products from sponsoring programmes before the watershed, in line with the Government’s original policy aims. Amendment 37, meanwhile, will make it clear that UK businesses producing online advertisements intended to be accessed principally by audiences outside the UK fall in scope of the exemption and will not be in breach of the less healthy food and drink advertising restrictions set out in the Bill. This amendment is needed to ensure that the legislation aligns with the Government’s policy intention to exempt advertisements made to be viewed outside the UK. We are confident that the likely frontline regulator already has a clear remit and tests in place that should allow it to apply this exemption effectively.
I shall now turn to the amendments relating to alcohol. I join the shadow Minister and put on record my tribute to the bravery of the hon. Member for Liverpool, Walton (Dan Carden), who has spoken so openly about the challenges he has faced, and to my hon. Friend the Member for Bury South (Christian Wakeford) for talking about his familial experiences. I am grateful to both of them for their bravery in doing that in a public place in this House.
As with meeting the challenge presented by obesity, this Government are committed to supporting the most vulnerable who are at risk from alcohol misuse, and we have an existing agenda for tackling alcohol-related harms. As part of the NHS long-term plan, we have invested £27 million in an ambitious programme to establish or improve specialist alcohol care teams in the 25% of hospitals with the highest rates of alcohol-dependence-related admissions. This is expected to prevent 50,000 admissions over five years. We have also made the largest increase in substance misuse treatment funding for 15 years, with £80 million of new investment in 2021-22.

Christian Wakeford: I reiterate the comment I made earlier that the best way to treat alcohol addiction and dependency is to treat it like a mental health illness, because that is what it is. The best way to do that is to remove the stigma and put more money into mental health, but in trying to overcome the stigma, we need to ensure that there is parity between mental and physical health. If we treat the mental health issue, we treat the alcohol issue. We cannot do one without the other. Will the Minister commit today to going some way towards doing that and to putting more money into mental health to deal with this?

Edward Argar: I am grateful to my hon. Friend. He will know that this Government have continued not only to highlight and promote parity of esteem between mental and physical health but to increase the funding available to mental health, reflecting that reality on the ground. He is right to highlight that issue.
We have announced a comprehensive set of reforms to alcohol duty in this year’s Budget which, taken with the steps we have put in place on a public health basis, have put in place a strong regime to tackle the consequences of alcohol misuse. We do not feel that this Bill is the place to legislate further on this issue but, as I have said, I am none the less grateful to the hon. Member for Liverpool, Walton for his amendments and for this opportunity to debate them.
On amendments 11, 12 and 13, this Bill would introduce a 9 pm TV watershed for less healthy food and drink products and a restriction on paid-for advertising of less healthy food and drink online. Those amendments, tabled by the hon. Member for Liverpool, Walton, would expand the definition of a less healthy product to include alcohol. This would have the effect of making alcohol advertising liable to the watershed proposed for TV programme services and the online restriction on paid-for advertising.
I reassure the hon. Gentleman, through Opposition Members, that the Government have existing measures in place to protect children and young people from alcohol advertising through the alcohol advertising code. Material in the broadcast code and the non-broadcast code relating to the advertising and marketing of alcohol products is already robust, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are suitably protected. If new evidence emerges that clearly highlights major problems with the existing codes, the Advertising Standards Authority has a duty to revisit the codes and take appropriate action. Furthermore, the Government introduced additional restrictions last year on alcohol advertising on on-demand programme services, through amendments to the Communications Act 2003.
Clause 129 and schedule 16 are aimed at reducing the exposure of children to less healthy food and drink advertising and the impact of such advertising on child obesity. Less healthy food and drink products—

Jonathan Edwards: Will the Minister give way?

Edward Argar: I fear that I have only a few minutes left, and I have already taken a number of interventions on this. I want to conclude by covering the tobacco amendments as well, which I know that some colleagues are keen to see a response to. I apologise to the hon. Gentleman.
Less healthy food and drink products are not age restricted at the point of purchase, unlike alcohol. Finally, the 2019 and 2020 consultations on advertising restrictions for less healthy food and drink did not consult on alcohol within the restrictions, either online or on TV, so we cannot be sure of the impact these amendments would have on the industry more broadly.
Turning to tobacco in the time I have left, because I know the shadow Minister, the hon. Member for Nottingham North (Alex Norris) , has taken a close interest in the issue, I thank the hon. Member for City of Durham (Mary Kelly Foy) and others, including my hon. Friend the Member for Harrow East, who have tabled a number of amendments that seek to address the harm caused by smoking in this country. I reassure the hon. Member for City of Durham of the Government’s commitment to becoming smoke free by 2030.
We have successfully introduced many regulatory reforms over the past two decades, and the UK is a global leader in tobacco control. Our reforms include raising the age of sale from 16 to 18, the introduction of a tobacco display ban, standardised packaging and a ban on smoking in cars with children, which all place important barriers between young people and tobacco products. The Government are currently developing our new tobacco control plan, and I reassure the hon. Lady that that will reflect carefully on the APPG’s findings and report.
I am afraid I cannot be tempted to go further than the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Erewash (Maggie Throup), did in the recent Westminster Hall debate on this question, but I can reassure the hon. Member for City of Durham that we remain committed to bringing forward the tobacco control plan.

Geraint Davies: rose—

Edward Argar: Forgive me; I only have a few minutes and I want to cover the amendments from the hon. Member for City of Durham. The hon. Member for Swansea West (Geraint Davies) did manage dexterously to shoehorn air quality more broadly within the scope of these debates, and what he said will have been heard.
New clause 2, which seeks to provide powers for the Secretary of State to impose a requirement for tobacco manufacturers
“to print health warnings on individual cigarettes and cigarette rolling papers”,
is intended, as I understand from the hon. Member for City of Durham, to further strengthen our current public health messaging and encourage smokers to quit. We strongly support measures to stop people smoking, to make smoking less attractive to young people and to educate smokers of its dangers, as we have done through graphic warnings on cigarette packs.
We would need to conduct further research and build a further robust evidence base in support of any such additional measures before bringing them forward. To date, no country has introduced such a measure, so there is currently limited evidence of its impact in supporting smokers to quit. If evidence showed that the requirement would not be effective, it would not be an appropriate power to have in place.
New clause 3, also tabled by the hon. Lady, seeks to provide a power for the Secretary of State to introduce a requirement for manufacturers to insert leaflets containing health information and information about smoking cessation services into cigarette packaging. As I set out in Committee, we believe this power is unnecessary, since the Department could legislate to do that already under the Children and Families Act 2014; inserts could be required for public health messaging through amendments to the Standardised Packaging of Tobacco Products Regulations 2015. We already have in place strong graphic images and warnings of the health harms of smoking on the outside of cigarette packs. As part of the Tobacco and Related Products Regulations 2016, the address for the NHS website, which provides advice for people seeking to quit smoking, is also required  on packaging.
The current SPoT regulations prohibit the use of inserts, as there was limited evidence that placing public health messaging inserts inside cigarette packages was more effective than messaging on the outside of packs. Further research would need to be undertaken to help to establish the public health benefit if we were to go further.
Turning briefly to new clause 4, I am grateful again to the hon. Lady for tabling this clause. The Government are clear that they only support the use of e-cigarettes as a tool for smokers who are trying to quit, and we strongly discourage non-smokers and young people from using them. We are committed to ensuring that our regulatory framework continues to protect young people and non-smokers from using e-cigarettes.
Current regulations include requirements on the packaging and labelling of e-cigarettes, along with restrictions on their marketing and the prohibiting of advertising on mainstream media such as TV and radio. While we strongly support measures to protect young people further from cigarettes, we believe the current regime remains appropriate and has the powers in place within it to make changes where required, although I suspect my hon. Friend the Member for Harrow East may yet be proved right when he suggests that the other place may return to this at some point.
I have outlined the many steps this Government are taking to address some of the major lifestyle challenges to our health. The Bill represents another step in the direction of preventive healthcare and building a healthier society, an aim I know we all share. I hope the House will support the amendments we have tabled at this stage to strengthen those measures.
I also want to update the House at this point, in the context of the importance of an integrated approach and how it can improve public health measures, on two steps the Secretary of State has taken today that will put NHS staff and technology at the heart of our long-term planning and allow us to take forward the integrated approach that has proved so vital during this pandemic and is so vital to public health.

Geraint Davies: Will the Minister give way?

Edward Argar: I am afraid I will not. I suspect that point will be pertinent to the debate on the first group of amendments tomorrow.
First, we intend to merge Health Education England with NHS England and NHS Improvement, putting education and training of our health workforce at the forefront of the NHS. By bringing this vital function inside the NHS, we can plan more effectively for the long term and have clear accountability for delivery.
Secondly, we also intend to take forward the recommendations of the Wade-Gery report, which included merging NHSX and NHS Digital with NHS England and NHS Improvement, building on the huge progress made on digital transformation during the pandemic and bringing together the digital leadership of the NHS in one place. I take this opportunity to pay tribute to all our colleagues at Health Education England, NHS Digital and NHSX for their exceptional work. These changes build on that contribution and allow us to drive forward further integration and changes that will put the NHS on a firmer footing.
I hope I have reassured hon. Members of the Government’s commitment to improving public health. I urge those who have tabled amendments to consider not pressing them to a Division.

Mary Foy: I have listened carefully to the debate, and I beg to ask leave to withdraw the clause.
Clause, by leave, withdrawn.

New Clause 4 - Packaging and labelling of nicotine products

“The Secretary of State may by regulations make provision about the retail packaging and labelling of electronic cigarettes and other novel nicotine products including requirements for health warnings and prohibition of branding elements attractive to children.”—(Mary Kelly Foy.)
This new clause would give powers to the Secretary of State to prohibit branding on e-cigarette packaging which is appealing to children.
Brought up, and read the First time.
Question put, That the clause be read a Second time.

The House divided: Ayes 230, Noes 297.
Question accordingly negatived.
Proceedings interrupted (Programme Order, this day).
The Deputy Speaker put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83E).

New Clause 16 - Annual report on alcohol treatment services: assessment of outcomes

‘(1) The Secretary of State must lay before each House of Parliament at the start of each financial year a report on—
(a) the ways in which alcohol treatment providers have been supported in tackling excess mortality, alcohol related hospital admissions, and the burden of disease resulting from alcohol consumption, and
(b) the number of people identified as requiring support who are receiving treatment.
(2) Alongside the publication of the report, the Secretary of State must publish an assessment of the impact of the level of funding for alcohol treatment providers on their ability to deliver a high-quality service that enables patient choice.”—(Alex Norris.)
This new clause would require the Secretary of State for Health and Social Care to make an annual statement on how the funding received by alcohol treatment providers has supported their work to improve treatment and reduce harm.
Brought up.
Question put, That the clause be added to the Bill.

The Committee divided: Ayes 194, Noes 298.
Question accordingly negatived.

Schedule 16 - Advertising of less healthy food and drink

Amendments made: 31,page222, leave out lines 9 to 11.
This amendment is consequential on Amendment 33.
Amendment 32,page222,line14, at end insert
“and anything else which, under a sponsorship agreement, is included in a television programme service, other than in a television programme;”.
This amendment makes it clearer that sponsorship credits in television programme services are included in the meaning of “advertising” in the new section 321A of the Communications Act 2003 inserted by Schedule 16.
Amendment 33,page222,line36, at end insert—
“(6A) Before making regulations under subsection (2)(b) or (6), the Secretary of State must consult such persons as the Secretary of State considers appropriate.”
This amendment requires the Secretary of State to consult before making regulations changing the meaning of “the relevant guidance” for the purposes of the television advertising provisions of Schedule 16.
Amendment 34,page223, leave out lines 7 to 9.
This amendment is consequential on Amendment 36.
Amendment 35, page223,line11, after second “advertisements” insert
“and sponsorship announcements (within the meaning given by section 368G(17))”.
This amendment makes it clearer that sponsorship announcements in on-demand programme services are included in the meaning of “advertising” in the new section 368FA of the Communications Act 2003 inserted by Schedule 16.
Amendment 36, page223,line34, at end insert—
“(7A) Before making regulations under subsection (3) or (7), the Secretary of State must consult such persons as the Secretary of State considers appropriate.”
This amendment requires the Secretary of State to consult before making regulations changing the meaning of “the relevant guidance” for the purposes of the provisions of Schedule 16 relating to advertising in on-demand programme services.
Amendment 37,page224,line21, leave out from “to” to “advertisements” in line 24.
This amendment widens the exception from the prohibition in new section 368Z14(3)(d) (online advertising of less healthy food and drink) for advertising not intended to be accessed principally from the UK, so that the exception applies to businesses in the UK as well as those outside it.
Amendment 38,page224, leave out lines 29 to 31.
This amendment is consequential on Amendment 39.
Amendment 39,page225,line22, at end insert—
“(8A) Before making regulations under subsection (4) or (8), the Secretary of State must consult such persons as the Secretary of State considers appropriate.”—(Edward Argar.)
This amendment requires the Secretary of State to consult before making regulations changing the meaning of “the relevant guidance” for the purposes of the provisions of Schedule 16 relating to online advertising.

New Clause 49 - Cap on Care Costs for charging Purposes

“(1) The Care Act 2014 is amended as follows.
(2) In section 15 (cap on care costs), for subsections (2) and (3) substitute—
‘(2) The reference to costs accrued in meeting the adult’s eligible needs is a reference—
(a) in so far as a local authority met the eligible needs, to how much of the cost of meeting those needs at the local authority’s rate the adult was required to pay (as reckoned from the amount that was specified in the local authority’s personal budget in respect of those needs (see section 26(2)(b)));
(b) in so far as a local authority did not meet the eligible needs, to what the cost of meeting those needs would have been at the rate of the responsible local authority (as reckoned from the amount that was specified in the personal budget (see section 26(2A)(a)) or the independent personal budget (see section 28(1)) in respect of those needs).
(3) A reference in subsection (2)(b) to eligible needs does not include any eligible needs during a period when the adult had neither a personal budget nor an independent personal budget, other than eligible needs during the period between the making of a request for an independent personal budget and its preparation.
(3B) For the purposes of this Part an adult’s needs are “eligible needs” if—
(a) the needs meet the eligibility criteria,
(b) the needs are not being met by a carer, and
(c) the adult is ordinarily resident or present in the area of a local authority.
(3C) In this Part, “the responsible local authority” means the local authority in whose area the adult is ordinarily resident or in whose area the adult is present (where the adult is of no settled residence).’
(3) In section 24 (the steps for the local authority to take), for subsection (3) substitute—
‘(3) Where no local authority is going to meet any of an adult’s needs for care and support, the local authority that is for the time being the responsible local authority must prepare an independent personal budget for the adult (see section 28) if—
(a) the adult has any eligible needs, and
(b) the adult has at any time asked a local authority that was, at that time, the responsible local authority, to prepare an independent personal budget.’
(4) In section 26 (personal budget), for subsections (1) and (2) substitute—
‘(1) A personal budget is a statement which specifies, in respect of the adult’s needs which a local authority is required or decides to meet as mentioned in section 24(1)—
(a) the cost of meeting those needs at that local authority’s rate,
(b) how much of that cost the adult must pay, on the basis of the financial assessment, and
(c) the amount which that local authority must pay towards that cost (which is the balance of the cost referred to in paragraph (a)).
(2) If the needs referred to in section 26(1) include eligible needs, the personal budget must also specify—
(a) the cost of meeting those eligible needs at that local authority’s rate,
(b) how much of that cost the adult must pay, on the basis of the financial assessment, and
(c) where the amount referred to in paragraph (a) includes daily living costs, the amount attributable to those daily living costs.
(2A) If the adult also has eligible needs which are not being met by any local authority, the personal budget must specify—
(a) what the cost of meeting those eligible needs would be at the responsible local authority’s rate, and
(b) where the amount referred to in paragraph (a) includes daily living costs, the amount attributable to those daily living costs.
(2B) References in this section to the cost of meeting needs at a local authority’s rate are to the cost that the local authority would incur in meeting those needs, assuming for the purposes of this subsection that the adult is not paying any amount in respect of those needs and has not expressed any preference for particular accommodation.’
(5) In section 28 (independent personal budget)—
(a) for subsection (1) substitute—
‘(1) An independent personal budget is a statement which specifies what the cost of meeting the adult’s eligible needs would be at the responsible local authority’s rate (but the independent personal budget need not specify the cost of meeting those needs at any time when the local authority required to prepare it has ceased to be the responsible local authority).’;
(b) after subsection (2) insert—
‘(2A) References in this section to the cost of meeting needs at a local authority’s rate are to the cost the local authority would incur in meeting those needs, assuming for the purposes of this subsection that the adult is not paying any amount in respect of those needs.’;
(c) omit subsection (3).
(6) In section 29 (care account), in subsection (1), in the words before paragraph (a), for the words from ‘the local authority’ to ‘present’ substitute ‘the responsible local authority’.
(7) In section 31 (adults with capacity to request direct payments), in subsection (1)(a), for ‘needs to which the personal budget relates’ substitute ‘adult’s needs which a local authority is required or decides to meet as mentioned in section 24(1) (see section 26(1)(c)).’
(8) In section 32 (adults without capacity to request direct payments), in subsection (1)(a) for ‘needs to which the personal budget relates’ substitute ‘adult’s needs which a local authority is required or decides to meet as mentioned in section 24(1)(see section 26(1)(c)).’
(9) In section 37 (notification, assessment etc.), in subsection (15), omit paragraph (a).
(10) In section 80 (Part 1: interpretation), in the table in subsection (1), at the appropriate places insert—

  

  ‘Eligible needs
  Section 15(3B)’


  ‘The responsible local authority
  Section 15(3C)’.”—(Edward Argar.)

  

This new clause makes amendments to the Care Act 2014 which would mean that the costs that accrue towards the cap on care costs are the costs incurred by an adult (at the local authority rate) rather than the combined costs incurred by both the adult and the local authority.
Brought up, and read the First time.

Edward Argar: I beg to move, That the clause be read a Second time.

Rosie Winterton: With this it will be convenient to discuss the following:
New clause 33—Support provided by the NHS to victims of domestic abuse—
“(1) Each Integrated Care Board must—
(a) assess, or make arrangements for the assessment of, the need for support for victims of domestic abuse using their services;
(b) prepare and publish a strategy for the provision of such support in its area;
(c) monitor and evaluate the effectiveness of the strategy;
(d) designate a domestic abuse and sexual violence lead; and
(e) publish an annual report on how it has discharged its duties relating to the provision of services to victims of domestic violence under the Care Act 2014.
(2) An Integrated Care Board that publishes a strategy under this section must, in carrying out its functions, give effect to the strategy.
(3) Before publishing a strategy under this section, an Integrated Care Board must consult—
(a) any local authority for an area within the relevant Integrated Care Board’s area;
(b) the domestic abuse local partnership board appointed by the local authority for an area within the relevant clinical commissioning group’s area under section 58 of the Domestic Abuse Act 2021; and
(c) such other persons as the relevant local authority considers appropriate.
(4) For the purposes of subsection (4), ‘local authority’ means—
(a) a county council or district council in England; or
(b) a London borough council.
(5) An Integrated Care Board that publishes a strategy under this section—
(a) must keep the strategy under review;
(b) may alter or replace the strategy; and
(c) must publish any altered or replacement strategy.
(6) The Secretary of State may by regulations make provision about the preparation and publication of strategies under this section.
(7) The power to make regulations under subsection (7) may, in particular, be exercised to make provision about—
(a) the procedure to be followed by an Integrated Care Board in preparing a strategy;
(b) matters to which an Integrated Care Board must have regard in preparing a strategy;
(c) how an Integrated Care Board must publish a strategy;
(d) the date by which an Integrated Care Board must first publish a strategy; and
(e) the frequency with which an Integrated Care Board must review its strategy or any effect of the strategy on the provision of other provision in its area.
(8) Before making regulations under this section, the Secretary of State must consult—
(a) all Integrated Care Boards; and
(b) such other persons as the Secretary of State considers appropriate.”
This new clause would require Integrated Care Boards to publish a strategy for the provision of support for victims of domestic abuse using their services and designate a domestic abuse and sexual violence lead.
New clause 55—Guidance for babies, children and young people—
“(1) The Secretary of State must publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25.
(2) Integrated care systems must act in accordance with the guidance in subsection (1).”
This new clause would require the Secretary of State to publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25 and would require integrated care systems to act in accordance with the guidance.
New clause 57—NHS England’s duty as to reducing inequalities—
“Section 13G of the National Health Service Act (duty as to reducing inequalities), is amended by the addition of the following subsections—
‘(2) NHS England must publish guidance about the collection, analysis, reporting and publication of performance data by relevant NHS bodies with respect to factors or indicators relevant to health inequalities.
(3) Relevant NHS bodies must have regard to guidance published by NHS England under this section.
(4) In this section “relevant NHS bodies” means—
(a) NHS England,
(b) integrated care boards,
(c) integrated care partnerships established under section 116ZA of the Local Government and Public Involvement in Health Act 2007,
(d) NHS trusts established under section 25, and
(e) NHS foundation trusts.’”
Amendment 47, in clause 6, page4,line11, at end insert—
“(5) In paragraph 1(a) ‘relevant public body’ means a public authority listed under the title ‘Health, social care and social security’ in Part 1 of Schedule 19 to the Equality Act 2010 or an NHS Trust.”
This amendment provides that NHS England resources for supporting or assisting organisations that are providing or planning to provide health services may only be directed to public sector bodies.
Amendment 58, in clause 12, page8,line6, at end insert—
“(2) An integrated care board may not—
(a) delegate that function; and
(b) exercise that function to enter into an integrated care provider contract with any body other than a statutory NHS body.
(3) In paragraph (2)(b) an ‘integrated care provider contract’ has the same meaning as in Schedule 3A of the National Health Service (General Medical Services Contracts) Regulations 2015.”
This amendment is designed to ensure that an organisation carrying out the functions of an ICB on its behalf is a statutory NHS body.
Amendment 59,page12,line29 at end insert—
“(3A) Nothing in——
(a) the rules referred to in subsection (1),
(b) this Act, or
(c) any regulations made under this Act
(none) shall entitle any provider of health services to withhold provision of those services from any individual on the basis of the integrated care board to which that individual has been allocated.”
This amendment is to ensure that any providers of health services cannot withhold provision of those services from any individual because of the integrated care board that they have been allocated to.
Amendment 66, in clause 15, page13,line44, at end insert—
“(j) palliative care services.”
This amendment adds a requirement for the commissioning of palliative and end of life care services.
Amendment 21,page14,line43, at end insert—
“3AA Duty of integrated care boards to commission approved treatments
‘(1) This section applies where—
(a) a treatment has been approved by the National Institute for Health and Care Excellence, and
(b) an integrated care board has not arranged for the provision of that treatment under section 3 or 3A of this Act, and
(c) a clinician has recommended that treatment for a person for whom that integrated care board has responsibility.
(2) The integrated care board referred to in subsection (1) must arrange for the provision of that treatment to the person for whom it has responsibility.
(3) In subsection (1) “clinician” means a medical professional employed by or acting on behalf of an NHS Trust, NHS Foundation Trust or primary care service from whom the integrated care board has arranged for the provision of services.’”
This amendment would require an integrated care board to arrange for the provision of a NICE-approved treatment to any patient whose NHS clinician has recommended it, even if that treatment is not otherwise available to patients in that ICB area.
Amendment 48, in clause 19, page16,line6, leave out “promotes” and insert
“secures the rights set out in”.
This amendment requires ICBs to act to ensure that health services are provided in a way which secures the rights set out in the NHS Constitution.
Amendment 99,page16,line34, at end insert—
“(2) In fulfilling their duties under this section, integrated care boards must have particular regard to the need to reduce inequalities between migrant and non-migrant users of health services.”
Amendment 49,page16,line37, leave out “promote” and insert “enable”.
This amendment, together with Amendment 50 provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment, rather than promoting their involvement.
Amendment 50,page16,line37, after “their”, insert “paid and unpaid”.
This amendment, together with the Amendment 49, provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment.
Amendment 22,page17,line4, at end insert—
“14Z37A Obligation on integrated care boards to ensure appropriate uptake of all NICE approved products according to population need
‘(1) Each integrated care board must promote uptake of all NICE approved medicines and medical devices in accordance with the need of the population it serves.
(2) An integrated care board must, in each financial year, prepare a report on the uptake of all NICE approved medicines and medical devices, including the number of patients that have accessed each product.’”
This amendment would require ICBs to ensure that all NICE approvals are available and promoted to their population, and report on this uptake annually.
Amendment 19,page17,line14, at end insert—
“14Z39A Duty to review latest innovations with a view to local commissioning
(1) Integrated care boards must review all new—
(a) medicines,
(b) medical devices, and
(c) other health care solutions that may benefit the local population.
(2) Integrated care boards must—
(d) appoint a dedicated innovation officer to their board, and
(e) develop and maintain a system to keep up to date with medicines and devices innovation and review suitability for patient usage, including engagement with the relevant—
(i) academic health science network, and
(ii) local pharmaceutical committee.”
This amendment would mandate integrated care boards to monitor and assess innovation for the benefit of the local population.
Amendment 16,page17,line19, at end insert—
“(2) Each integrated care board must each year prepare, consult on and adopt a research strategy for patient benefit which—
(a) meets local need;
(b) meets national research undertakings.
(3) In developing a strategy under subsection (2), an integrated care board must engage with—
(a) the National Institute for Health Research,
(b) academic health science networks, and
(c) all other relevant regional and national health research organisations.”
This amendment would require ICBs to establish a research strategy and other connected measures.
Amendment 91,page18,line18, after first “the” insert “physical and mental”.
This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.
Amendment 92,page18,line23, after first “of” insert “physical and mental”.
This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.
Amendment 68,page18,line26, at end insert—
“(d) health inequalities.”
This amendment would modify the triple aim to explicitly require integrated care boards to take account of health inequalities when making decisions.
Amendment 17,page18,line38, at end insert—
“14Z43A Duty on integrated care boards to consider requests to engage in clinical trials, and patient participation
(1) An integrated care board must consider any request from the organiser of an authorised clinical trial for the ICB to engage in that trial.
(2) If such a request is accepted, the integrated care board must offer the ability to participate in the trial to any patient within their area who is eligible to take part.”
This amendment would require integrated care boards to consider any requests to engage in clinical trials and offer patients the opportunity to participate.
Amendment 20,page18,line38, at end insert—
“14Z43A Duty to update formularies to include all NICE-approved products
(1) Within 28 days of any medicine or device receiving market authorisation from NICE, an integrated care board must update its formulary to include that medicine or device.
(2) On receipt of notice of the market authorisation by NICE of any medicine or device, an integrated care board must immediately instruct providers of health and care services commissioned by the board to update their formularies in such a way that all NICE-approved medicines and devices are available to patients on the recommendation of a healthcare practitioner within 28 days of market authorisation.
(3) An integrated care board must report annually all medicines and devices that have been added and removed from their formulary over the previous year.”
This amendment would mandate integrated care boards and healthcare providers (e.g. hospital trusts) to update their formularies to include all NICE-approved medicines or devices within 28 days of market authorisation to ensure they are available for healthcare practitioners (e.g. physician or prescribing pharmacist) to make available for suitable patients.
Amendment 102,page21,line25, at end insert—
“(c) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).”
This amendment requires the joint forward plan for an integrated care board and its partners to set out any steps it proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).
Amendment 51,page22,line23, leave out
“in a way that they consider to be significant.”
This amendment requires ICBs and partner NHS Trusts and NHS Foundation Trusts to consult on all revisions to their forward plans.
Amendment 52,page23,line42, at end add “on its website”.
This amendment is to require capital resource use plans to be made publicly available on the internet.
Amendment 53,page24,line22, leave out
“in a way that they consider to be significant”.
The purpose of this amendment is to require all revisions of capital resource use plans to be published.
Amendment 18,page25,line6, at end insert—
“(d) explain what research activity it undertook during the year, including
(i) research to meet local health issues, and
(ii) research to support national research projects.
‘(2A) The annual report prepared by the Secretary of State under section 247D of this Act must include a section which reproduces, and comments on, the sections of the annual reports of each integrated care board prepared under paragraph (1)(d).’”
This amendment would require integrated care boards to publish an account of their research activity, and require the report the Secretary of State must prepare and lay before Parliament under section 247D of the National Health Service Act 2006 to include a section which reproduces, and comments on, the research activity of all ICBs.
Amendment 23,page25,line14, at end insert—
“14Z56A Report on assessing and meeting parity of physical and mental health outcomes
(1) An integrated care board must annually set out in a report the steps it has taken to fulfil its obligations to deliver parity of esteem between physical and mental health to its local population.
‘(1) The report must set out—
(a) the number of patients presenting with mental health conditions,
(b) the number of patients presenting with physical health conditions,
(c) the number of mental health patients waiting for initial assessment,
(d) the number of physical health patients waiting for initial assessment,
(e) the number of mental health patients waiting for treatment,
(f) the number of physical health patients waiting for treatment,
(g) the number of mental health patients receiving treatment,
(h) the number of physical health patients receiving treatment,
(i) the number of patients readmitted to mental healthcare settings, and
(j) the number of patients readmitted to physical healthcare settings.
(2) The report must set out performance against nationally set standards in both physical and mental health.
(3) Each year the Secretary of State must lay before Parliament a consolidated report of all the reports made by integrated care boards under this section, and make a statement to each House of Parliament on the report.’”
This amendment would require an ICB to report on assessing and meeting parity of physical and mental health outcomes.
Amendment 15, in clause 20, page29,line20, at end insert—
“(2A) The Secretary of State may by regulations make provision about representation of particular health, social care, and local interests, clinical fields, and types of health or care provision in the membership of integrated care partnerships.”
This amendment would enable the Secretary of State to make provision about the membership of integrated care partnerships.
Amendment 100,page29,line22, at end insert—
“(4) A member of the Integrated Care Partnership may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”
This amendment seeks to ensure that Integrated Care Partnerships are made up wholly of representatives from public sector organisations and that private companies are not represented on them.
Amendment 1,page29,line45, at end insert—
“(c) fully integrate the promotion of everyday wellbeing, self-care for minor ailments and the management of long-term conditions into local health systems.”
This amendment would ensure that everyday wellbeing, self-care for minor ailment and management of long term conditions are integrated and promoted into local health systems.
Amendment 2,page30,line3, after “services” insert
“including services provided by pharmacists for minor ailments”.
This amendment would ensure that integrated care partnerships include in a strategy its views on how health-related services, including provision for self-treatable conditions, are integrated into health and social care services in that area.
Amendment 69, in clause 23, page35,line32, at end insert—
“(5) NHS England must publish guidance on the means by which an integrated care board, NHS trust or NHS foundation trust which believes its capital resource limit or revenue resource limit risks compromising patient safety may object to the limit set.”
Amendment 114, in clause 25, page37,line27, at end insert—
“(2A) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.”
The Secretary of State has the function of setting priorities for the Care Quality Commission in carrying out assessments in relation to integrated care systems. This amendment requires the Secretary of State to set priorities relating to certain matters.
Amendment 61,in clause 64, page59,line27, leave out from beginning to end of line 28.
This amendment is to ensure that a commissioner cannot also be a provider.
Amendment 62,in clause 69, page63,line30, leave out “may” and insert “must”.
This amendment makes it a requirement that regulations make provision in relation to the procurement by relevant authorities of (a) health care services for the purposes of the health service in England, and (b) other goods or services that are procured together with those health care services.
Amendment 63,page63,line36, leave out “may” and insert “must”.
This amendment makes it a requirement that regulations make provision in relation to (a) general objectives of procurement, and (b) procurement processes.
Amendment 64,page63,line39, leave out “may” and insert “must”.
This amendment along with Amendment 65 makes it a requirement that regulations make provision for the purposes of (a) ensuring transparency and fairness in relation to procurement, and (b) ensuring that compliance can be verified, or managing conflicts of interest.
Amendment 65,page63,line41, leave out “or” and insert “and”.
This amendment is to make it a requirement for regulations to make provision to ensure both transparency and fairness in relation to procurement.
Amendment 9,page64,line1, at end insert—
“(3A) The regulations must provide that—
(a) there is a presumption—
(i) in favour of contracts being awarded to NHS trusts and NHS foundation trusts, and
(ii) that integrated care provider contracts will not be awarded to a body other than to an NHS trust or an NHS foundation trust, except for under the provisions of paragraph (b);
(b) if an NHS trust or an NHS foundation trust does not consider that it is able, or does not wish, to provide certain services under a contract, it must publish its reasons;
(c) if paragraph (b) applies, the integrated care board must consult the public if it proposes to award any contract for those services to any body other than an NHS trust or NHS foundation trust;
(d) a consultation under paragraph (c) must—
(i) set out the responses of the integrated care provider to the reasons given by the NHS trust or NHS foundation trust under paragraph (b),
(ii) specify the proposed parties to and the full terms and conditions of the proposed contract, and
(iii) specify that the terms and conditions for staff under the proposed contract must be at least equivalent to NHS terms and conditions.”
This amendment would make NHS trusts and foundation trusts the default providers of NHS services.
Amendment 72,page64,line1, at end insert—
“(3A) The regulations must make provision in relation to the procurement of the services referred to in paragraph (1)(a) (other than primary medical services, primary dental services and primary ophthalmology services) that before any contract for a service with an annual value in excess of £5m may be awarded to an organisation that is not an NHS trust or NHS foundation trust—
(a) the business case for the award of the contract must be published;
(b) any responses to the proposal in the business case must be considered and published;
(c) the process for awarding the contract must be open and transparent and non-discriminatory at every stage, including (but not limited to)—
(i) procurement strategy and plan,
(ii) invitation to tender,
(iii) responses to invitations,
(iv) evaluation of tenders,
(v) decision to award, and
(vi) contract awarded;
(d) the process for awarding the contract must demonstrate due regard to the principles established in the Public Contracts Regulations 2015 (S.I.2015/102) or any regulations which may supersede them;
(e) in any case where it is claimed that an emergency justifies an award without the process being used then the responsible body must within 14 days publish the business case for the award of the contract and the record of the decision.”
Amendment 101, in schedule 2, page125,line26, at end insert—
“(3) Members of an Integrated Care Board may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”
This amendment seeks to ensure that ICBs are made up wholly of representatives from public sector organisations and that private companies, their employees and representatives, and those with financial interests in them, are not represented on ICBs.
Government amendments 25 to 28.
Amendment 76,page126,line26, at end insert—
“(d) at least one member nominated by the mental health trust or trusts that provide mental health services within the integrated care board’s area;
(e) at least one member nominated by the Directors of Public Health that serve each local authority within the integrated care board’s area;
(f) at least one member nominated jointly by any NHS trust, NHS foundation trust and local authority that provides social care services within the integrated care board’s area;
(g) at least one member nominated by the trade unions representing the health and social care workforce that serves the integrated care board’s area;
(h) at least one member appointed to represent the voice of patients and carers in the integrated care board’s area.”
Amendment 77,page126,line26, at end insert—
“(2A) The constitution must prohibit representatives of GP practices with active Alternative Provider Medical Services contracts from becoming members.”
This amendment would mean that the only GPs able to participate in Integrated Care Boards would be those whose practices are on the standard General Medical Services (GMS) contract.
Amendment 78,page126,line26, at end insert—
“(2A) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to NHS decision-making boards, integrated care boards, or any place-based committee or sub-committee of the boards.”
Amendment 81, in schedule 2, page130,line14, at end insert—
“(7) An integrated care board may enter into an externally financed development agreement in respect of any Local Improvement Finance Trust relevant to the area for which it has responsibility and receive the income related to that agreement.
(8) An integrated care board may enter into an externally financed development agreement in respect of any proposed Local Improvement Finance Trust relevant to the area for which it has responsibility.”
This amendment would enable integrated care boards to participate in existing and future LIFT schemes and to receive the income that would come to the local area from the local investment in such schemes.
Amendment 79, in schedule 3, page132,line28, leave out “person” and insert
“general practitioner, GP partnership or social enterprise providing primary medical services”.
This amendment would prevent an integrated care board from entering into or renewing any Alternative Provider Medical Services (APMS) contract.
Amendment 80,page132,line32, leave out “person” and insert
“general practitioner, GP partnership or social enterprise providing primary medical services”.
This amendment would prevent NHS England from entering into or renewing any Alternative Provider Medical Services (APMS) contract.
Government amendments 29 and 30.

Edward Argar: New clause 49 has attracted a slightly fuller House than my previous speech did. This additional clause relates to the cap on care costs for charging purposes.
On 7 September, my right hon. Friend the Prime Minister took the bold step of publishing “Build Back Better: Our Plan for Health and Adult Social Care”. Successive Governments over decades have failed to tackle the reform of social care. This Government are delivering a package—package is the key—of reforms that will not only tackle the wider challenges faced by the adult social care system but reform how social care is funded to ensure that everyone, regardless of where they live or their level of assets, is protected from catastrophic costs. Let me remove all doubt on this issue: no one will lose from these reforms, compared with the system we have now, and the overwhelming majority will win.
Underpinning the reforms set out in the plan is an additional £5.4 billion over the next three years. That funding will end wholly unpredictable care costs and include at least £500 million to support the adult social care workforce. The reforms will make a real difference to the frontline of adult social care, including care users and the dedicated care workforce who have performed heroics throughout the pandemic. A crucial element of the reforms in the plan are the proposals to reform the existing social care charging rules.

Damian Green: I am grateful to the Minister for giving way so early in his speech. I am glad to hear him assert that no one will lose out and most people will win. Will he publish an impact assessment that will allow us to look at the detailed figures? As he will be aware, there is much commentary about the distribution of the possible losses, which seems to me to be an extremely important and sensitive issue for the Government to address.

Edward Argar: My right hon. Friend has long taken a close interest in this issue. In a moment, I will come to some of the figures and changes; I hear what he says about giving the House and the other place the information that they need and the aim is to do exactly that.

John Baron: rose—

John Redwood: rose—

Edward Argar: I will make a little progress and then give way to my hon. Friend the Member for Basildon and Billericay (Mr Baron).
Currently, one in seven adults over 65 faces care costs of more than £100,000 over their lifetime. We are capping the amount that anyone will be forced to spend on personal care costs in their lifetime at £86,000. That is a seismic and historic change in the way we pay for care in England.

John Baron: The Government deserve credit for grasping this nettle, which has evaded Governments of both parties for too long, but he must understand that there is a real cause on the Government Benches in respect of the distribution of the relative losses and the worry that those who are less well off will be hit hardest by the Government’s new clause. Will he address that issue?

Edward Argar: I understand where my hon. Friend and Members from both sides of the House are coming from. This is the first major step forward in the reform of social care that we have seen in decades and must be seen as part of an overall package of changes.

Barbara Keeley: rose—

Edward Argar: I would like to make a little progress, if I may.
The reforms will make the existing means test far more generous. We are increasing the upper capital limit from £23,250 to £100,000, which will make masses of people with moderate assets eligible for some state support towards the cost of care earlier, and the lower capital limit will also increase, from £14,250 to £20,000. Below that level, people will contribute only from their income, fully protecting their savings and assets below £20,000.
Over recent days, people have compared our policy proposals to previous, abandoned and never-enacted proposals for reform. I am clear that our proposals will deliver the changes needed where others have failed and see a significant improvement on the system that is in place today.

Barbara Keeley: rose—

Catherine West: rose—

Edward Argar: We have considered what help people want and when they want it.

John Redwood: rose—

Edward Argar: My right hon. Friend rose earlier and I should have taken his intervention then; I hope he will forgive me.

John Redwood: I am grateful to the Minister. Will he confirm that the amount of tax that is going to be raised in the immediate future, in national insurance and then in a separate tax, will make up a relatively small minority of the total costs of public social care?  Will he also confirm that none of these measures addresses the issue of the hotel costs that people need to pay when they go into care homes?

Edward Argar: My right hon. Friend is right to highlight that this is talking about personal care costs, so he is right in his point on that.
Did I see the hon. Member for Hornsey and Wood Green (Catherine West) rise earlier?

Catherine West: The Minister did indeed. He is being very generous in giving way. A lot of research went into the work by Mr Dilnot some time ago and a very independent assessment was made. Can he explain why, in this clause, he is going away from those recommendations and taking a fresh look at it?

Edward Argar: While the hon. Lady and I do not always agree on everything, she asks a perfectly a reasoned and measured question. I pay tribute to Andrew Dilnot’s work on his report. I just happen to think that, on this point, we diverged from what he proposed and we believe that what we are proposing is the right way forward. We have always intended for the cap to apply to what people personally contribute, rather than on the combination of their personal contribution and that of the state. It will mean that people with fewer chargeable assets meter towards the cap more slowly, because they are paying much less each week than people who are entirely self-funding. This amendment will make it simpler to understand the amount that will go towards the cap and make it fairer.

Barbara Keeley: rose—

Jon Ashworth: rose—

Edward Argar: If the shadow Secretary of State will forgive me, the hon. Lady has attempted on a number of occasions to get in, so it is only fair that I give way to her.

Barbara Keeley: On the point the Minister is making about the Dilnot proposals and a comparison, let me tell him that the Alzheimer’s Society said that 15% of people with dementia in the north-west would reach the cap under the Government’s proposals, compared with 34% under Dilnot’s proposals. That is a massive amount, and those are the people, with their families, who are paying hundreds of thousands and pounds. That is the comparison.

Edward Argar: I am grateful to the hon. Lady. I do not think that she posed a question, but she made her point clearly, as she always does.

Matthew Hancock: rose—

Bob Neill: rose—

Edward Argar: If I may make a little progress, I will then give way to my former boss, the former Secretary of State, and then, if I have time, to my hon. Friend.
To reiterate, as my right hon. Friend, the Prime Minister, said on 7 September, nobody—nobody—will be “worse off” than under the current system. Currently,  around half of all older adults in care receive some state support for their care costs. This will rise to roughly two thirds under these reforms. This clause would also make a number of minor technical amendments to other sections of the Care Act 2014.

Jon Ashworth: Will the Minister give way?

Edward Argar: Before I give way to the right hon. Gentleman, I will give way to the former Secretary of State.

Matthew Hancock: Is not the right way to think about this change to consider the proposal in front of us and compare it with the current system? The reason that the Dilnot system, as previously proposed, was never put in place was that there was never a proposal to pay for it, whereas this package is paid for. That is why this Government have been able to deliver a package where no previous Government have been able to do so.

Edward Argar: I am grateful to the former Secretary of State. He is absolutely right. We deal in the reality and we should compare the reality of the system that we have in place now with what we have proposed here, which not only moves us forward, but is funded and sustainable.

Bob Neill: Can my hon. Friend help me on two short matters? Can he give us an assurance that there will be no adverse impact on local government financing in relation to this, and that he will talk to the Local Government Association, if necessary, in this regard? Secondly, he says that it is part of a package. My right hon. Friend the Member for Ashford (Damian Green) referred to the impact assessment. Does he agree that it is only fair that, at the very least, we have an impact assessment before the Bill completes its passage through both Houses?

Edward Argar: Yes, of course, as we move through this reform process, it is absolutely right and vital that we work with our partners in the Local Government Association and local authorities of all political complexions. In respect of the impact assessment, I do believe that it is important that we have an impact assessment before this legislation completes its passage through both Houses.

Jon Ashworth: I am extremely grateful to the Minister. He is showing his typical courtesy in giving way. Many across the House are puzzled because we recall this document that the Government placed before the House when they asked the House to endorse the national insurance increase. Indeed, many Members did endorse that national insurance increase, even though they were breaking a manifesto commitment. This document actually says that it will introduce a care cap and
“deliver a core recommendation of the independent Dilnot Commission. It will be implemented using legislation already in place under the 2014 Care Act, which introduces the independent Dilnot Commission’s social care charging reform.”
It goes on to describe that as the “new cap”. Why have the Government moved away from the position of just a few months ago that they published ahead of a vote on   increasing national insurance and moved to a policy now that disproportionately benefits those with greater assets, which surely cannot be fair?

Edward Argar: I am grateful to the shadow Secretary of State who, while I do not necessarily agree with what he says, as ever puts it courteously. We hold true to what we put in that “Build Back Better” document. It is necessary for this one particular element to see further primary legislation, hence the amendment today.

Karin Smyth: Will the Minister give way?

Edward Argar: I am afraid that I will not give way because I do need to make some progress.

Karin Smyth: Will the Minister give way on that point?

Edward Argar: I have been very generous with my time and to the shadow Front Bench, so forgive me, but no.

Karin Smyth: On that point, will the Minister please give way? Six weeks in Committee and not a mention.

Edward Argar: Forgive me, but no.
To reiterate, as my right hon. Friend the Prime Minister said on 7 September nobody—nobody—will be “worse off” than under the current system. Currently around half of all older adults in care receive some state support. This will rise to roughly two thirds under these reforms. On the minor technical amendments that I made to other sections of the Care Act, I would not wish to belabour each one, but I can reassure the House that those changes will ensure that the legislation works as intended and that everyone who is eligible—

Karin Smyth: Will the Minister give way?

Edward Argar: I will not give way. I want to make some more progress.

Paul Bristow: Will my hon. Friend give way?

Edward Argar: I want to make a little more progress. I will not give way to one of my hon. Friends or to the hon. Lady at this moment.
This will be done by amending the provisions to clearly describe the information that must be included in a personal budget so that individual contributions count towards the cap at the local authority determined rate, and to ensure that personal budgets and independent personal budgets work as they were originally intended when being used in conjunction with the cap.
Before turning to integrated care boards, let me put it on record that, once again, this must be regarded as part of a package of measures that improves significantly on the current provision in place for those funding care.

Philip Dunne: I am extremely grateful to my hon. Friend for giving way. Before we leave the subject of the cap, can he just confirm that this proposal includes the costs of domiciliary care, which had not been included under the original Dilnot proposals that are exercising Labour Members?

Edward Argar: My right hon. Friend is exactly right. I am grateful to him for giving me an opportunity to highlight that this improves in this respect on the Dilnot proposals. I put on record my tribute to Andrew Dilnot for his work, but we believe that this is a better package, and, as he highlighted, a sustainable package from a financial perspective.

Karin Smyth: Will the Minister give way. We have had six weeks in Committee.

Edward Argar: The hon. Lady implores me, saying that after six weeks of having to sit opposite me in Committee, the least I can do is allow her to intervene.

Karin Smyth: Several times in that Committee, I offered to help the Government in a cross-party way. The Minister has been dealt a bad blow here tonight, having to come here and defend this proposal. In those six weeks—I think 21 sessions—not one iota of this proposal was mentioned or brought forward. We all know about bad legislation, rushed legislation, and legislation that does not have the commitment on something so important. I have commended the Government for starting this conversation, but this is a poor legislation move. I am sure that Members here would support the Minister tonight if he were to withdraw this proposal, go back to the Chancellor and ask him to think again. We would all be behind him if he took that opportunity.

Edward Argar: I did wonder whether I would regret that intervention. It was typically courteous, although I have to say that when a Member of the Opposition says that, “We’re here to help you”, I am not always sure. [Interruption.] Of course, when the hon. Lady does it, I know that she is sincere about it. The point I make is that this important change is necessary to deliver on the pledge we have made. It is being introduced on Report. While ICBs and integrated care systems, which we will speak about shortly, are hugely important, I suspect that this matter will dominate the debate in this group on Report. Equally, I suspect that it will be fully debated and scrutinised in the other place.

Paul Bristow: Does the Minister agree that we have been on a journey? The context of this needs to be considered. We are starting a conversation, but other things will come. There will be bumps in the road, but the context that we need to consider is that this is the first Government to tackle the issue of social care in decades. That is the right way to look at this piece of legislation. It should not be looked at in a short-term way.

Edward Argar: I am grateful to my hon. Friend, a member of the Health and Social Care Committee, for his intervention. He makes the point well that this is another step on the journey, but it is a journey that only this Government have actually got round to starting. Previous Governments have failed to make that progress. The previous Labour Government produced two Green Papers, one Royal Commission, and one spending review and nothing was done, so this Government are making significant progress.

Barbara Keeley: Will the Minister give way?

Edward Argar: I have already given way to the hon. Lady, so I will not do so again.
I thank the hon. Member for Bristol South for her words, but the situation is not as she characterises it with my having been dealt a difficult or challenging hand this evening. I am proud to stand here and defend this Government as the first Government to make changes to tackle the social care challenges that this country faces.

Paula Barker: Will the Minister give way?

Edward Argar: I have given way a number of times and I want to make some progress. I will be winding up the debate, so hon. Members will have the opportunity to come back in then.

Liz Kendall: Will the Minister give way?

Edward Argar: I am afraid that I will not give way now.

Jon Ashworth: For Leicestershire!

Edward Argar: I did give way to the right hon. Gentleman, the shadow Secretary of State, and he is my other constituency neighbour in Leicestershire.
Let me turn to integrated care boards and integrated care partnerships. I remind the House of what my right hon. Friend the Secretary of State said on Second Reading. These bodies are critical for delivering the key aims of the legislation: reducing bureaucracy; supporting integration and collaboration; and improving accountability. At the heart of the legislation for these bodies is flexibility—giving systems the scope to shape structures according to their needs. This principle is widely supported across the NHS and local government, and we would not want to imperil that, which is why we will be resisting attempts this evening to constrain more tightly how ICBs and ICPs operate. However, we recognise that there are a number of points of clarification that would be helpful to include, and we have tabled a number of amendments to do just that.
Before we reach the meat of this section, there are a number of minor amendments to deal with. First, minor and technical Government amendment 29 will update a reference in the Health and Social Care (Community Health and Standards) Act 2003 to reflect the changes made to section 99 of the National Health Service Act 2006. Secondly, Government amendment 30 will designate integrated care boards as operators of essential services under the Network and Information Systems Regulations 2018. This will place requirements on ICBs to protect their network and information systems by managing risks to ensure service availability and prevent patient harm.
We expect ICBs to take decisions on IT investment, including on cyber-security, and owning systems—and the associated cyber-risk—that are critical to the provision of healthcare. This includes holding the shared care record. The loss or corruption of data from the shared care record could have clear implications for the delivery of care, and for wider public trust in the digitisation and data-sharing agenda. We must take this risk seriously, and assure ourselves that ICBs are doing so as well.

Kevin Hollinrake: May I take the Minister back to new clause 49, very briefly? He is right to point out that some measures that he has brought forward are more generous than previously proposed, but there is no doubt that the way that the cap works means that it is less generous for those with more modest assets. Does he not agree? How can that be fair?

Edward Argar: I simply take my hon. Friend back to my previous point: when compared to the current system, this is a significant improvement and step forward, particularly when taken in the round with the overall package of measures that see the floors go from £23,250 up to £100,000 and from £14,250 up to £20,000. We have to look at this issue in the round, considering all those aspects rather than purely one element alone.

Mel Stride: Will the Minister give way?

Edward Argar: I would like to move on to ICBs and ICSs, but I suspect that, assuming there is time, my right hon. Friend, who chairs the Treasury Committee, may have the opportunity to intervene during my winding up, or to give a speech during the course of the debate.
Currently, the NIS regulations cover NHS providers in England, rather than commissioners. Government amendment 30 allows us to mitigate cyber-risk in a wider sense, making cyber-security a responsibility for organisations that have duties across the system, and to drive forward a shared and collaborative effort towards reducing the risk to patients. I hope that Government amendments 29 and 30 will be uncontentious and supported on both sides of the House.

Liz Kendall: Will the Minister give way?

Edward Argar: On ICBs, which I have moved on to, but not on new clause 49.

Liz Kendall: Is the Minister absolutely sure about what he said in response to the hon. Member for Thirsk and Malton (Kevin Hollinrake)—that everybody would be better off under new clause 49 than they are now? Is it not the case, as illustrated by the Health Foundation, that people with very modest homes, worth less than £106,000, will never hit the cap and therefore will not be better off under the Government’s proposed system than they are now?

Edward Argar: I make the point to the hon. Lady that I made in my opening remarks; I said that no one would be worse off and the majority would be better off. That is the point that I make to her: people would not be worse off. If she looks at Hansard, she will see that those were my original remarks when I opened this debate.
Let me turn to the amendments that the Government are introducing on the membership of integrated care boards. Government amendments 26 to 28 are minor and technical, and simply make it clear that the constitution of an ICB may provide for more than one member to be nominated by NHS trusts and NHS foundation trusts, primary medical service providers or local authorities. The proposed legislation sets out the minimum membership of the integrated care board, which needs to include  members nominated by those bodies. However, local areas can go beyond the legislative minimum requirements in order to address their local needs. We want to make it clear that that includes being able to nominate more than one member from those sectors to sit on the board, if that is what is best for the local system.

Paula Barker: Will the Minister give way?

Edward Argar: On ICBs, but not on new clause 49. We have moved on and I need to make some progress, because I know that many Members want to speak.

Paula Barker: I thank the Minister for giving way; he has been very generous with his time. Does he agree that if true integration and genuine parity of esteem are to be achieved, it should be written into law that local authorities should have a seat on the ICB?

Edward Argar: Local authorities will have a seat on ICBs and on ICPs. The approach set out in the legislation is appropriate. We have sought throughout for it to be permissive, not prescriptive, and that remains the right approach.

John Redwood: Will the Minister give way on ICBs?

Edward Argar: May I make a little bit of progress? Depending on time, I may then give way to my right hon. Friend. I am conscious that hon. and right hon. Members want to speak—I suspect, primarily on new clause 49.
I turn to Government amendment 25. In doing so, I thank the hon. Member for Ellesmere Port and Neston (Justin Madders), whose birthday it is today—I wish him a happy birthday; I am sure that he can think of nothing that he would prefer to be doing—and the hon. Member for Nottingham North (Alex Norris) for their discussions about this issue. I do not know what view they have reached, but I am grateful for the helpful spirit in which they approached those conversations.
Although service provision—I emphasise the word “provision”—by the independent and voluntary sectors has been an important and valuable feature of the system under successive Governments, it was never the intention for independent providers to sit on integrated care boards and it still is not. We were clear that the conflict of interests provisions addressed the issue, despite misleading and inaccurate claims by some campaigners. However, we are happy to put the matter even further beyond doubt.
Government amendment 25 makes it clear that no one may be appointed to an ICB who would undermine the independence of the NHS, either as a result of their interests in the private healthcare sector or otherwise. We expect this to prevent, for example, directors of private healthcare companies, significant stakeholders of private healthcare companies and lobbyists from sitting on the board of an ICB. It would also prevent anyone with an obvious ideological interest that clearly runs counter to the NHS’s independence from sitting on a board of an ICB.

John Redwood: Will the Minister give us a brief comment on the recruitment of chief executives and senior management to the boards? Will we be using people who already have senior NHS jobs, meaning that  there will be no redundancy and transfer costs, or will there be quite a redundancy bill because we want to change personnel?

Edward Argar: I think my right hon. Friend is talking about executive posts. Yes, there will be processes in place to ensure that employment rights are respected. There will be some roles that are completely new and there will be a competition, but I would expect that those with a significant track record and experience would therefore find themselves in a strong position. I will not prejudge any of those individual decisions.

Charles Walker: rose—

Edward Argar: I will give way to my right hon. Friend.

Charles Walker: I am not a right hon. Member, but I am very happy to take the promotion.
I have tabled a number of technical, totemic amendments on parity of esteem that appear on today’s amendment paper and tomorrow’s. They propose taking general references to “health” in the Bill and changing them to “physical and mental health”. I hope that the Minister will receive those amendments with his usual generosity and make the necessary changes over the next two days.

Edward Argar: I take my hon. Friend’s amendments in the spirit in which they are of course intended. I recognise the importance and value that those on both sides of this House put on parity of esteem of mental and physical health. I suspect that we may debate the amendments in subsequent groupings and I look forward to responding then.
We have, in the process of drafting this amendment, heard suggestions that we should simply ban private company employees completely from the boards of ICBs. I am afraid that doing so is not so simple, nor would it achieve the desired result in all cases. In fact, our amendment goes further to underline the importance of NHS independence than would an amendment that focused purely on banning employees of private providers. There are clearly some candidates who would be suitable but may have minor interests in private healthcare. GPs, for example, do provide, and have provided, their excellent knowledge and experience of their patients in guiding commissioning decisions, and some may have private practices as well. Excluding them would be to lose their experience from the NHS, and therefore such an involvement with the private sector would clearly not risk undermining the independence of the NHS.

Daniel Poulter: I draw the House’s attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. A number of GPs have, in recent times, sought to group together into confederations of practices, which could create a bloc interest within a local board area. How will that potential conflict of interest in the commissioning and provision of services be addressed by the Government through legislation?

Edward Argar: I am grateful to my hon. Friend, who knows of what he speaks in terms of the operation of healthcare services. We would not wish to exclude GPs or groups of GPs from being able to participate in decision making. That expertise, as we have seen with  clinical commissioning groups, can be hugely valuable. What we have sought to do, in an amendment that is technically worded, for want of a better way of putting it, is to strike the right balance while also ensuring that the additional measures on the constitutions of the ICBs and ICPs have to be approved by NHS England to avoid any obvious conflict of interest. But we are not seeking to avoid GPs being able to operate in that space and sitting on ICBs.

Clive Efford: Will the Minister give way?

Edward Argar: I would like to make a little progress and then I will give way to the hon. Gentleman, who has been bobbing for some time.
We believe—this may not answer the hon. Gentleman’s point, but I will make a little progress and then if there is time—[Interruption.] Well, we will see. Hope springs eternal. A blanket ban on employees of private companies would also, we fear, be arbitrary. It would not cover the full range of people involved in non-NHS providers, some of whom may not be suitable candidates to sit on ICBs because of their involvement, but not employment, within the private healthcare sector. With the complex corporate structures that providers may have established, a narrow definition in the Bill could be unhelpful and risk not capturing the people we wish to capture.

Chris Grayling: I support what my hon. Friend is saying. It would be crazy to exclude primary care because it is effectively a private healthcare business, and therefore what he is saying is enormously important. In support of my hon. Friend the Member for Broxbourne (Sir Charles Walker), I believe it would be absolutely wrong, looking at my own county, if the mental health trust did not have a presence in the governorship of the ICB. I hope that the Minister will ensure a presence not only for the conventional trusts in hospitals and in primary care but for the mental health trusts, because their role is vital and the integration of services is essential to the delivery of good mental health care.

Edward Argar: My right hon. Friend makes a point that came out in some of the oral evidence sessions on the Bill. Our aim was to create a minimum membership for the ICBs and ICPs, but it is not prescriptive—it can go beyond that—so there is scope for mental health trusts or other health trusts to have seats on those boards. Indeed, Dame Gill Morgan, who runs the integrated care system in Gloucestershire, said that that is exactly what she has done and that she would be surprised if any ICB did not wish to do it. But we wanted to set a de minimis membership to allow for local flexibility.

Clive Efford: We have GP practices that are being privatised now—they are being bought up by private companies, with some foreign interests as well. If the Minister is saying that those companies can have representation on ICBs, we have already seen circumstances where people have tried to redact minutes of meetings, so does this not open up the possibility of private interests being served at these meetings but not being accountable through public scrutiny?

Edward Argar: I entirely understand the point the hon. Gentleman is making. I think he was careful, shall we say, given some litigation that may be going on, not to mention anything specific, but I know what he is talking about. We believe that our amendment will prevent private companies—whatever services they were providing for the NHS—with a significant private interest in this, or their lobbyists, from being able to sit on ICBs. The hon. Member for Bristol South (Karin Smyth) raised the need for transparency in Committee a number of times, and I suspect we may return to that point. We believe that the current transparency requirements on CCGs that will be carried across are sufficient to ensure transparency and public access to the information they need.

Geraint Davies: rose—

Edward Argar: I am afraid I am about to conclude. I suspect that the hon. Gentleman will come back in with a speech and I will endeavour to pick up on that in the wind-ups.
There are a number of similar amendments, such as amendment 101 in the names of the hon. Members for Wirral West (Margaret Greenwood) and for Brighton, Pavilion (Caroline Lucas). I hope they might feel, to some degree, reassured by our amendment and the intent behind it, but that is obviously for them to say. We believe that the Government’s amendment puts beyond doubt what we believe was already entirely clear but were determined to put beyond doubt—that ICBs will not and cannot be controlled in any way by the private sector, as NHS-accountable bodies guided by the NHS constitution and with NHS values at their heart. These principles, I believe, irrespective of other debates we may have this evening, command respect from both sides of this place. I therefore commend the amendments to the House.

Justin Madders: A wide range of issues that are part of this group of amendments demonstrate the cold reality of this Bill. It is a jumble sale of bits and pieces. Of course a Bill can be wide-ranging, but having breadth is not the same as having coherence, or indeed clarity. Such are the issues within scope in this grouping that I will not comment directly on every new clause and amendment but hope to have time to say at least a few words on those emanating from the Opposition Front-Bench team, as well as on any Government new clauses or amendments that we oppose. Some amendments refer to matters that have been dealt with in Committee where we have expressed our views and put forward amendments that failed to persuade the Government. Sadly, we have insufficient time to go over the same ground again, particularly given the rapid shifting of the goalposts we have seen in the past week.
I turn first to integrated care boards, or ICBs, and, more widely, the issue of governance. The question of governance and accountability remains an important matter to us and needs greater clarity than currently appears in the Bill. For Members who may not be familiar with the detail, the Bill proposes yet another reorganisation of the NHS, creating 42 new integrated care systems where decisions on how NHS and care spending will be made. The decision-making bodies within these systems are the ICBs, replacing the CCGs,  which fall away into the annals of history alongside the primary care groups, the primary care trusts and all the other permutations that we have seen.
Our discussions on these matters in Committee showed that our disagreements tended to centre around an intention by Government to limit what is in statute and to leave maximum flexibility at local level, as opposed to our desire to ensure that safeguards and protections were in place for those matters we felt were too important to be left out. It is wholly ironic, therefore, that the Bill proclaims, on the one hand, local freedoms and flexibilities, yet on the other proposes sweeping top-down powers for NHS England and the Secretary of State. Our view remains that some flexibility is fine to allow shaping to local needs, but that some key principles need to be put into the Bill to ensure that there are no misunderstandings or unintended consequences.
We know that the genesis of this Bill has been the realisation that increasingly large parts of the NHS were ignoring the 2012 Lansley Act. Along with changes to procurement and pricing, this grouping deals with the main elements of reversing parts of that Act. We could spend all our time referring to what we said 10 years ago, and how the Health and Social Care Act 2012 has proved to be the disaster that we said it would be, but we will spare the Government the “We told you so” lectures, because even those on the Government Benches are now aware that the 2012 Act has been among the worst policy mistakes in the history of the NHS. Whether that damage was worse than the damage done by a decade of austerity remains to be seen, but repairing the damage done by austerity is not for today, as there is little in the Bill to address the ongoing consequences of a decade of underfunding, particularly the wholly appalling waiting times that we now see across the board.
What became clear in Committee was that the Bill is an NHS reorganisation with little to say on social care. In fact, until last week at least, just two clauses out of 135 related to social care. We get one system of procurement replaced by another that resembles Swiss cheese, and we get nothing at all in the Bill on funding flows and pricing. We were originally told that this was a Bill for integration, but halfway through its consideration, we were told there would be a White Paper along shortly to deal with integration. At least that means there is recognition that the Bill will not deliver the promised land of integration—if, indeed, it is the promised land—but in the meantime, the Government will expect people to crack on with this reorganisation, taking them away from the day job.
On Second Reading, we said that the Bill was
“the wrong Bill at the wrong time.”—[Official Report, 14 July 2021; Vol. 699, c. 438.]
It does not address any of the vital issues facing the NHS. Since then, on every metric, the NHS is performing worse. The challenges have got greater ahead of what is widely expected to be the most difficult winter in the NHS’s history. The NHS does not need yet another reorganisation when the fundamental challenges it faces remain untouched. The explanatory notes and impact assessment for the Bill are both sketchy at best. For example, we do not know what this reorganisation  will cost the NHS, and there is certainly nothing in the Bill about social care caps, but we will return to that later.
Then there is the justifiable fear about private sector providers being given a seat on the ICB, although, as the Minister has said, there does appear to be general agreement that something should be done about that, so this debate is more about the how than the why. I appreciate the efforts made by the Minister with amendment 25 in trying to find an accommodation with us, and his birthday wishes. He is absolutely right; there is no place I would rather be than in this Chamber discussing health and care integration. I am afraid we will not be able to support Government amendment 25, because it does not go far enough in our opinion. It adds unnecessary subjectivity into matters and it is not comprehensive in its coverage.
Amendments 76, 77 and 78 deal with the issue and would limit the possibility for influence by vested interests, especially those of the private, for-profit sector. Crucially, they close the door on the possibility, left open by the Government’s amendment, of private providers sitting on sub-committees or place-based bodies of ICBs. Incidentally, that problem is of the Government’s own making by virtue of them leaving the level of direction for place-based Government arrangements deliberately vague in the Bill.

Geraint Davies: Perhaps my hon. Friend can illuminate me. I was going to ask the Minister who owns the assets of the ICBs. Can the ICBs sell some of those assets and rent them back as a service? What constraints are there to stop people on the board enabling that, because they have some strange link to the people buying the assets?

Justin Madders: At the moment, ICBs are not a legal entity, so they do not own anything. When the Bill comes into force, they will effectively take over mainly administrative buildings from the CCGs, and the trust will hold ownership of most of the assets. We hope that there will not be the risks that my hon. Friend outlines, although it is not impossible for ICBs to set up their own trusts at some point in the future.
We do not believe that the question of private providers sitting on the place-based boards can be left open in this way, because this is really about who runs the NHS. There is a complete and utter incompatibility between the aims of private companies and what we say should be the aims of the NHS and the ICBs. I can do no better than refer to the evidence of Dr Chaand Nagpaul from the Bill Committee. He identified the concern perfectly:
“We forget at our peril the added value, the accountability, the loyalty and the good will that the NHS provides. We really do…I am saying that it does matter. Your local acute trust is not there on a 10-year contract, willing to walk away after two years. It is there for your population; it cannot walk away.”––[Official Report, Health and Care Public Bill Committee, 9 September 2021; c. 90, Q113.]
Those final words sum it up perfectly. Put a company on the board, and its interest lasts as long as the contract, and those interests will of course not be the same as the NHS’s anyway. A company’s primary concern is the shareholders, not the patients. With that clear and unanswerable concern about conflicts of interest, we invite the Government to withdraw their amendment and support ours.
We have already had some discussion of who goes on the ICB. Apparently, the answer is not the most appropriate people chosen by an independent external process or individuals directly accountable to the public; the answer is left to guidance that leaves open the risk that voices we think need to be heard will slip through the net. Our amendment 76 deals with that by setting out the requirements for ICB membership. Allocating scarce NHS resources should be robustly debated and will always be political. Tough choices have to be made, so we need people on the ICB who will be there to cover all the necessary interests for the wider good.
If Members look at what amendment 76 suggests, I hope nobody would argue that those interests do not have to have some voice. The public, patients, staff, social care, public health and mental health—which of those can be safely ignored and which has no part to play? As I have already mentioned, there is a major area of uncertainty because of the complete absence of anything that sets out how the much-vaunted place-based commissioning will work. Who will sit at the place-based table is, I am afraid, still completely opaque.
The next major area covered in the Bill is a further deconstruction of Lansley with the removal of compulsory competitive tendering for clinical services. We have seen the NHS proposals for a provider selection regime to replace the regulations under section 75 of the 2012 Act. That is to be regarded as a work in progress, so our amendment 72 covers the issue and would reintroduce some safeguards into how our money is spent. Since its inception, the NHS has always relied on some non-NHS providers, with the model developed for GPs being an obvious example. However, in recent decades there has been an increase in the use of private providers of acute care, most notably in diagnostics and surgery.
To be clear, we on the Opposition Benches believe that the NHS should be the default provider of clinical services. If it is not the only provider, it should be the predominant provider in geographical and services terms. Where a service cannot be provided by a public body because the capability or capacity is not there, there is still the option to go beyond the NHS itself, but that should be a last resort and never a permanent solution. Amendment 72 therefore sets out a clear framework for how we could achieve that. We hope that extra transparency and extra rigour would mean we avoid buying stuff that is unsuitable and sits in container mountains, stuff that does not meet specifications, and stuff made by companies that have no experience, but are owned by friends and family. In short, we would stop the covid crony gravy train.
The use of private sector capacity in the covid emergency turned out to be a farcical failure. It became very clear, very quickly that it was not there to support the NHS; it was there just to make profits. Use of private providers through dodgy deals during the PPE scandal has highlighted the need for greater transparency and greater capacity in the NHS. We can never allow a repeat of what we have seen there. We need the rigour set out in the amendment to be put into legislation, rather than left to guidance. We need to be able to challenge NHS bodies that do not comply, as well as Ministers who try to flout the rules.
I will now deal with new clause 49, saving the best—or more accurately, the worst—until last. Because of how Report stage works, it has fallen to me to express our  opposition to this measure, rather than my expert colleague, my hon. Friend the Member for Leicester West (Liz Kendall), who shares my dismay at what has been produced and how it has been presented to us. Starting with the process, it is wholly wrong to bring such a fundamental change forward as a last-minute addition to this Bill. That means it cannot be debated properly today. There is no impact assessment and, as we have already heard, this change was not discussed in Committee at all. In fact, in 22 Committee sessions spanning some 50 hours, we never once heard mention of this amendment coming forward or discussion on the care cap. Indeed, when this Chamber was busy debating the social care levy, we were beavering away in Committee on the Bill, oblivious to the fact this measure was coming down the track. If the Government cannot even get their decision-making processes integrated, what hope is there for integrating health and social care?
As we know, the aim of the new clause is to remove means-tested benefits from the costs that count towards the care cap. As has been pointed out far and wide by Members from all parts of the House, that change adversely impacts some more than others. It is a wholly regressive measure, to say the least, to give support through means-testing, but then to penalise people later for receiving it in the first place. We will vote against this iniquity, and I hope many Conservative Members will vote with us. They should be used to the Prime Minister’s broken promises by now; this is their chance to make the point that he should stand by what he says.

Mike Amesbury: Does my hon. Friend agree that it is Robin Hood in reverse? I encourage Conservative Members who wax lyrical about levelling up, particularly in the north, to do the right thing.

Justin Madders: My hon. Friend must have sneaked a look at my speech, because I will say later that it is Robin Hood in reverse.

Barbara Keeley: The proposal is grossly unfair. I gave the example earlier that in our region, 15% of people with dementia will reach the cap, whereas 34% would have under the Dilnot proposals. The cap also does not protect working-age adults who are accessing social care, or people with a disability, but Sir Andrew Dilnot’s proposals would have done. It is the second major area in which the proposal is grossly unfair.

Justin Madders: Again, my hon. Friend must have read my speech because I will make that point later. The proposal shows that the Bill is not a plan to fix social care but a very thin attempt to change parts of the system. There are many other elements that clearly need dealing with.
In case Conservative Members need reminding, in the Prime Minister’s first speech on taking office, he promised to,
“fix the crisis in social care once and for all, with a clear plan that we have prepared”.
We are still to see that plan. What we have is a new tax and a broken promise.

Alison McGovern: My hon. Friend and neighbour is making an excellent speech. We should be talking about a plan for social care, but we are actually talking about a tax on the people who have lost out over the past decade and more from the excessive house price growth in the south compared with other parts of the country. This is a tax that doubles down on inequality, rather than addressing it.

Justin Madders: I thank my hon. Friend and neighbour—I am getting all my neighbours in tonight. She makes a brilliant point: the proposal exacerbates regional inequalities through an unfair tax and is certainly not a plan to fix social care. Hon. Members should look at what my hon. Friend the Member for Leicester West has said about what needs to be done to tackle the social care crisis in this country; it is an awful lot more than putting in place a cap that benefits only some people in certain parts of the country.
Not only will the proposal not stop people having to sell their home to pay for their costs, but it will bake in unfairness for a generation. It does nothing for working adults with long-term care needs, who seem to have been completely missed out, as my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) said. It is not what was promised, but hon. Members do not have to take my word for it. Let us listen to the experts. Age UK says:
“The change the Government has announced makes the overall scheme a lot less helpful to older people with modest assets than anyone had expected. It waters down Sir Andrew Dilnot’s original proposal to save the Government some money, but at the cost of protecting the finances of older home owners…This feels like completely the wrong policy choice and we are extremely disappointed that the Government has made it”.
The King’s Fund says of people with more modest assets that,
“the Prime Minister’s promise that no one need sell their house to pay for care…doesn’t seem to apply to them.”
Instead, it will only “benefit wealthier people”.

Barry Gardiner: My hon. Friend referenced the Prime Minister’s statement that nobody would have to sell their house to pay for social care. I know that my hon. Friend would never seek to call the Prime Minister a liar in this Chamber, but does he wonder, as many hon. Members do, why the Bill appears to be turning the Prime Minister’s words into a lie?

Justin Madders: I thank my hon. Friend for his intervention—I think. What I can say here and what I might say outside are not the same, and I do have to finish my speech, so I will leave it there. I am sure that the public will make up their own minds about the veracity or otherwise of comments made by the Prime Minister.
Sir Andrew Dilnot said that the proposals will create a north-south divide, that those with assets of £106,000 will be hardest hit and that anyone with assets under £186,000 will be worse off than under his proposals. According to the Health Foundation, assuming care costs of about £500 a week, those with assets of £150,000 will take a year and a half longer to reach the cap than they would have under the Dilnot proposals, those with assets of £125,000 will take four and a half  years longer, and those with assets of under £106,000 will never reach the care cap. Contrary to what the Minister has said, people with assets of £106,000 or less will not benefit from the proposal at all.
The Dilnot commission specifically said that excluding state contributions from the cap would be unfair for those on lower incomes and would mean that they would contribute the same as the wealthy over a longer period, but that is where we find ourselves today with the new clause. Ordinary people on modest incomes will pay an extra tax that will not stop them having to sell their home to pay for their care costs, but that will mean the mansion-dwelling millionaires can keep theirs.
As my hon. Friend the Member for Weaver Vale (Mike Amesbury) said, we have a reverse Robin Hood situation. People on lower incomes will pay into a system that they will see little benefit from, but that will protect 90% of a property worth £1 million. In case hon. Members need help translating that into what it means for their constituents, I have a selection of median house prices in various constituencies across the country: in Hartlepool, the median house price is £128,000; in Bishop Auckland, it is £125,000; in Blackpool South, it is £114,000; in Stoke-on-Trent Central, it is £112,000; in Hyndburn, it is £110,000; and in Burnley, it is £99,000. The owners of such houses would all probably have to sell their homes under these plans.
Those figures are replicated across huge areas of the country, so it is not just a few people in those constituencies who will lose out, but thousands of people, mainly in the midlands and the north of England, who will be forced to sell their home while those in more affluent areas of the country can keep theirs. That is not fairness or fixing social care, but a betrayal. We on this side of the Chamber always thought that levelling up was just a slogan with little substance, but we now know that it is worse than that. It is a con trick—a lie—that will leave many of those whom it was meant to support worse off than they would have been otherwise.
Conservative Members who loyally trooped through the Lobby in September to impose the social care levy, knowing that it would have a disproportionate impact on their less well-off constituents who paid into it, must now—to use a phrase that we have heard many times in the last week—be suffering from buyer’s remorse. It must have dawned on them that they have been sold a pup, that there is no plan to fix social care, that the Bill will not stop people having to sell their home, and that the only people it will help are those who are already comfortably well off.
The only way that Conservative Members can represent their constituents, who voted for them because they believed that the Conservative party had changed and was at last on the side of ordinary people, is by joining us in the Lobby to vote against the Government, and by showing that they will not stand for a Government who break their promises. When the chickens come home to roost, and families in their constituency say to them, “We were promised that we wouldn’t have to sell our home to pay for care costs,” what will they say? Will they tell them that they voted for it even though they knew what would happen? Will they tell them that promises do not really matter? Or will they tell them that when it came to the crunch, they stood up for what  is right and what is in the interests of the people they were elected to represent, and said to the Government, “No. Think again”?
Finally, I remind Conservative members of the manifesto on which they stood for election, which said clearly and unambiguously of social care that,
“The prerequisite of any solution will be a guarantee that no one needing care has to sell their home to pay for it.”
If they do not think that the Government new clause gives that guarantee, and if they think that it breaks the promise they made to the electorate, they should join us in the Lobby, take back control and vote against it.

Several hon. Members: rose—

Rosie Winterton: Order. It will be obvious to Members that a large number of colleagues want to contribute to the debate. I urge brevity, so that others can participate. I call the Chair of the Health and Social Care Committee, Jeremy Hunt.

Jeremy Hunt: Madam Deputy Speaker, I think on this occasion I can oblige you, because I will be very brief. I wish to speak to amendment 114, which may seem a rather technical amendment—as is evidenced by the fact that, out of 650 colleagues, only one has actually signed it, and that is me—but it makes up in quality for what it does not have in quantity. It is about making sure that the new integrated care boards focus their energy on the safety and quality of care of patients. That is very important, because the new integrated care boards will have enormous power. In effect, they will be the local governing bodies of our NHS.
Although the statutory structures matter, what the people running those care boards focus their attention on is incredibly important to all our constituents. The amendment will make sure that when care boards consider their priorities, the things that matter to patients—the safety and quality of care—are put at the very top of their list. We know the way the NHS works. It is the fifth-largest bureaucracy in the world, and there is a plethora of internal NHS—

Edward Argar: rose—

Jeremy Hunt: I see the Minister wants me to give way. May I make my argument for one moment, and then give way?
There is a plethora of internal NHS targets, there are operational targets and there are financial targets. They often have an excellent purpose, but, as in the case of Mid Staffs and other cases where things went badly wrong, being under a lot of pressure to meet those targets means corners can be cut, and the quality of care experienced by patients can be really damaged. The amendment would make sure that there was discipline in the system, so that whatever pressure NHS managers were under, they were always focused on safety and quality of care.

John Redwood: I pay tribute to my right hon. Friend for what he did as Secretary of State to stress the importance of this crucial work, and he is not on his own: I support him.

Jeremy Hunt: Before I come to the Minister, I want to say—and I am very grateful to my right hon. Friend the Member for Wokingham (John Redwood), who gave me consistent support on this agenda when I was Health Secretary—that, in the public sector, the one system that has seemed to make sure we focus public bodies on our constituents’ priorities is the Ofsted system in schools. We have rolled that out, I think reasonably successfully, to hospitals, GP surgeries and care homes, and this amendment makes that possible for the new integrated care boards. I want to give the Minister a chance to intervene to tell us his reflections on whether this system could work.

Edward Argar: I am grateful to my right hon. Friend. It is not just my right hon. Friend the Member for Wokingham (John Redwood) who supports him on this; I and the Government do, and we are delighted to accept his amendment.

Jeremy Hunt: I am most grateful to my hon. Friend, and I am also grateful to the Opposition, who have indicated that they will not oppose the amendment.

Kevin Hollinrake: Now that that one is sorted, would my right hon. Friend offer the House his views on new clause 49?

Jeremy Hunt: I am happy to do that, because I know my hon. Friend has a great interest in social care issues. I feel conflicted by new clause 49. I think that what we will end up with after this measure will be a whole lot better for people on low incomes than what we had, because the means-test threshold will be raised from £23,000 to £100,000, and that is a very significant improvement. However, I have to be honest and say that it is nothing like as progressive as we had hoped, but it is a step forward. My concern when it comes to social care is that our entire debate is focusing on what does and does not contribute to the cap, when the fundamental problem in social care is the core funding to local authorities; that, though not a matter for this Bill, has a direct impact on the care received by our constituents.
I conclude by thanking the Government for their support for amendment 114. I will move it formally later, but I am not expecting to divide the House on it.

Philippa Whitford: I initially want to touch on new clause 49. Like other members of the Bill Committee, I sat through hours and hours from September to November, and the Government have suddenly pounced on us with this at the last minute. It is such a complicated new clause, but it has not been interrogated.
It is quite clear that the Government’s original spin that no one would pay more than £86,000 for social care and no one would have to sell their house is completely misleading. All the accommodation costs are on top of this. As has been highlighted in the media and by Members in the Chamber, those with assets of about £100,000 will not see any real gain from this policy, while those sitting on assets of £500,000 or more will keep a lot of their wealth. That means it exacerbates the differences, and penalises those in the north of England and areas where house values are not so high. Basically, it is feeding the frenzy down here of people sitting on over-inflated house prices. As has been said, this is not levelling up, just doubling down.
The cap applies only to personal care, which means things like washing and dressing. That has been provided free in Scotland both within the care home and in home care since 2002. It was expanded in 2011 to provide more hours so that people with greater need could stay at home longer, and it was extended to those under 65 with care needs in April 2019. Scotland is the only UK nation that provides free personal care, and we see it as an investment. It is an investment that we spend 43% more per head on social care in Scotland, but it is an investment in people’s independence and their inclusion in society. The problem is that we spend far too much time talking about social care just as a burden, instead of actually seeing it from the point of view of the user.
The Scottish Government have already added an extra penny on taxation for medium and high earners to cover things such as our wellbeing policies, health or social care, but this Government’s plan to increase national insurance contributions will disproportionately hit low-paid workers and young workers. I would say that the biggest weakness of all, as we know from the original debate on the national insurance change, is that the funding is not going to go to social care initially; it is going to go to the NHS, yet it is social care that is in crisis. This is what is causing the pressure in accident and emergency, because people who are ready to be discharged simply cannot be, as the care support is not there. I do not think that this fixes the problem. There will actually be very little money, because a lot of it is going to go on capping the overall payment. I do not see social care benefiting from this at all, yet it is social care that needs investment more than anything else.
Turning to the main substance of the Bill, which is meant to some extent to unpick the damage and fragmentation of the Health and Social Care Act less than a decade on, I wish to express support for amendments 9 and 72. Many in the NHS, including me, will be glad to see the back of section 75 enforced tendering. Others in the Chamber know that it was the Health and Social Care Act that brought me into politics, as I just could not believe anybody thought what they were doing was a good idea. It is still clear from the pandemic that this Government are absolutely wedded to outsourcing services to private companies, and to the flawed notion that financial competition somehow drives up clinical quality. I am sorry, but that simply is not the case. As the Chair of the Health and Social Care Committee has highlighted, we have to focus on safety, on clinical audit, and on peer review if we want to drive up care quality for patients, not just on the money in the system.
The Government appear to have conceded that integrated care boards should be statutory bodies, as health boards have always been in Scotland, but partnership boards can include private providers, such as with Virgin Care in Bath. As the partnership boards will be involved in devising the local strategy for health services, that is likely to lead to a blatant conflict of interest, and I do not see a resolution to that. The NHS simply should be the presumed provider of health services. That is not just, as the shadow Health Minister said, because the NHS is in it for the long term, or for a quick contract, but because the NHS provides the training to nurses and doctors who are the vital workforce of the future. Private providers do not do that; private providers largely live off the NHS. As well as not training staff,  where there are major problems or complications, patients inevitably end up in the intensive care unit of an NHS hospital.
In conclusion, for all the size of the Bill, and the scale that the reorganisation will involve for staff in the NHS, who we all know are frankly exhausted, the Government have failed to take the opportunity to repair fully the damage of the Health and Social Care Act 2012, and to recreate in England a unified public health system, such as the one we are lucky enough still to have in Scotland.

Anne Marie Morris: I thank the Minister for the time he gave me to consider my amendments, which we discussed in some detail, and I thank Her Majesty’s Opposition who, very kindly, took some of my amendments through Committee, sadly unsuccessfully. Tonight I hope to have the opportunity myself to explain why these amendments are so important. Before the House thinks, “Oh my goodness, how can we possibly deal with that many clauses and amendments?” let me say that I will endeavour to be brief. I rise to speak to new clause 33, and amendments 21, 22, 19, 16, 17, 20, 18 and 23—but I will be brief.
Let me divide my remarks into four topic areas: domestic abuse, mental health, access to medicines, and research. New clause 33 deals with domestic abuse. That is a horrific crime. It is insidious, it is hidden, and it is on the rise, and during the pandemic it has, sadly, grown from strength to strength. I say, pointedly, that this is a hidden crime, and at the moment, all the teeth are with the police. However, the police can deal only with very evident crime.
Where does domestic abuse first appear? It is in a doctor’s surgery, or at accident and emergency. To date, however, there is no obligation on clinical commissioning groups, integrated care boards or hospitals to come up with a strategy to address that horrific ill. New clause 33 would place a new obligation on ICBs to put in place a proactive strategy to properly manage that issue, and to introduce the education and training that GPs and those in hospitals and A&E need. We must ensure that we no longer find, as in the Safelives report, that those experiencing domestic abuse will have experienced it for three years before it is picked up, despite having already been to visit their GPs almost five times. I do not believe that that is acceptable in a civilised society such as the one we have today.
Five and a half per cent. of adults between 16 and 74 experience such abuse, and the Home Office has determined that the cost of that was £66 billion in 2016-17. Of that, £2.3 billion was the cost to the health service. We know that 23% of those who are at risk attend A&E, and yet nothing happens. I am fortunate that in Devon we have a pilot. My CCG is the only one in the country to have a dedicated individual on the board who specifically oversees and sets a dedicated strategy on this issue. The estimate from the pilot so far reckons that if we spent £450,000 a year on our GPs in Devon, we would get a return of £7 million. But this is not about money; this is about what is the right thing to do. Until this measure is on the statute book, and until there is an obligation to put in place a strategy, this will not change, and I cannot sit here and accept that.
Let me turn to mental health. For many years and in many documents, we have seen a commitment to parity of esteem, but I have been through every statute on the book and at no point is there any reference to the words “parity of esteem for mental health”. If parity of esteem for mental health is not on the statute book, how can we say we believe in it? If it is not on the statute book, how can we possibly measure it? Currently, there are very few measures of inputs or outputs—or, worse, of outcomes —for those going through the mental health system. There are some, but they are minuscule compared with what we have for physical health.
Amendment 23 to clause 19 would require each ICB to compare the inputs and outputs on physical health and mental health. Each ICB would be required to set out: the number of patients presenting with physical symptoms and with mental symptoms; the waiting times for initial assessment in physical health and in mental health; the waiting times for treatment in physical health and in mental health; the number of patients actually receiving treatment in physical health and in mental health; and, finally, reports on readmissions. I know that Ministers do not like that level of detail, but how important is this? Without some very specific measures, it will not happen. What gets measured generally gets done.
Amendment 23 would also require the ICBs to report against the very few national standards that there are. At least then we would see what they were; we would shine a bright light on the fact that there are so few for mental health while there are numerous for physical health. The Secretary of State would be required to consolidate those reports into a national report, which would have to be presented to Parliament—to both the Commons and the Lords. What is there for Ministers not to like about that amendment? What is there for those on the Opposition Benches not to like about it?

Jon Ashworth: We like it!

Anne Marie Morris: Then I would like to see you wishing to press it to a vote and putting your vote—and your feet—where your mouth is. [Interruption.] I apologise, Madam Deputy Speaker; it is not your mouth. I was carried away by an overwhelming desire to get my point across, and I apologise most profoundly.
I turn to access to medicines. Most Members believe, do they not, that medicines that have been approved by the National Institute for Health and Care Excellence are available to all our constituents? The reality is that they are not. A medicine may have gone through the Medicines and Healthcare products Regulatory Agency and been proved to be safe, and through NICE and been said to be cost-effective, but each CCG—each ICB, as they will be—and hospital trust, and every other NHS body responsible for prescribing, sets its own formulary, and those formularies do not include all NICE drugs. If a medicine is not on the formulary, then no consultant or GP will be able to get reimbursement, so they will not be allowed to prescribe it.
In my constituency, a number of individuals have come to me because they cannot get access to a particular medicine, yet people in another constituency can. I do not believe that a postcode lottery is right. We all talk about the NHS, and health and care, being free at the point of delivery, and we all assume that we can get   access, whether to GPs or to hospitals, but I do not think it occurs to most of us—it had not occurred to me—that we cannot necessarily get access to medicines.
My amendment 21 to clause 15 would effectively oblige every ICB, where any individual patient has the advice of their clinician that they should have a particular medicine and it has been approved by NICE, to make provision to ensure that that medicine is provided—perhaps from a neighbouring ICB, taking advantage of the duty to collaborate across ICBs. That would ensure that even if a medicine was not on the formulary in the area of an individual ICB, it could be obtained from another area. Bear in mind that there is no financial loss in doing that, because all NICE-approved drugs are subject to a voluntary pricing agreement between the pharmaceutical companies and NHS England. Under that agreement, x number of drugs will be provided at an agreed cost. Anything above that will be reimbursed by the drug company, so the Government and the NHS will not be out of pocket. Why would that not be a good clause? To provide belt and braces, under amendments 20 and 22, all NICE treatments would automatically be added to all formularies within 28 days of market authorisation and every ICB would be obligated to report.
My last area—I will be very brief, Madam Deputy Speaker—is research, which is so important, as we discovered during the pandemic. I would like to draw the attention of the House to some of the challenges. Some of the anti-viral solutions to coronavirus were late to market because we could not get the clinical trials. Why? Because we could not get access to the records of the patients who had had covid or been diagnosed with covid so that we then had the appropriate cohort to be able to test the anti-virals. It therefore seems very clear that research must be taken on board across every hospital trust and across every ICB. If every ICB and hospital trust had in place a system to ensure research was part of their DNA—that they had to report on what research they were undertaking and had an obligation, if they were asked and had the appropriate cohort, to recruit the patient base so that particular clinical trials could take place—we would get more medicines faster to market. I think most people would say that that was a win.

Rob Roberts: I declare an interest in that my partner is a clinical research nurse—working in cardiac research—so I completely appreciate and understand exactly where the hon. Lady is coming from. Does she agree that to find patients for studies, often tens of thousands of pounds is spent on radio and online adverts? If her amendment 17 is successful, it could be revolutionary for research in this country.

Anne Marie Morris: I thank the hon. Gentleman. He is absolutely right. If we could have this new system, so there was a research strategy and an obligation to consider clinical trial requests and then report, we would be in a very different place.
Madam Deputy Speaker, you have been incredibly indulgent and so have all hon. Members. On that note, having had my time for my four areas, I thank the House for its indulgence and I look forward to the Minister’s reply.

Margaret Greenwood: The Bill opens the NHS up to big business, allowing private companies a say in the care that patients receive. The Government’s amendment to the make-up of integrated care boards is weak and it fails to rule out the possibility of people with an interest in private health sitting on them. For that reason I tabled amendment 101, which seeks to ensure that ICBs are made up wholly of representatives from public sector organisations and that private companies, their employees and representatives, and those with financial interests in them, are not represented on them. Surely, that is what the public expect from a body that will be responsible for spending huge amounts of public money?
However, the influence of private companies is not just an issue with ICBs. The Bill allows for private companies to play parts in other ways, for example at sub-system level via place-based partnerships and provider collaboratives—they are not actually stated in the Bill, but that is what it means. Guidance by NHS England states very clearly that the Health and Care Bill will enable ICBs to delegate functions to providers, including, for example, devolving budgets to provider collaboratives. There is nothing to stop such partnerships from being open to big business, so the Government’s rhetoric around protecting the independence of ICBs is, frankly, quite meaningless. For all their talk of recognising
“that the involvement of the private sector, in all its forms, in ICBs is a matter of significant concern to Members in the House,”
they have not taken the action needed to stop private companies from influencing decision making. That is why I have put forward amendment 58, which is designed to ensure that any organisation carrying out the functions of an ICB on its behalf is a statutory NHS body.
Although the Government have made some noise about private membership of integrated care boards, they have said with respect to integrated care partnerships that they
“want local areas to be able to appoint members as they think appropriate.”––[Official Report, Health and Care Public Bill Committee, 14 September 2021; c. 258-259.]
That is a matter of great concern. ICPs are required to
“prepare a strategy…setting out how the assessed needs in relation to its area are to be met”.
Integrated care boards must have regard to a strategy drawn up by the ICP, which may well be influenced by private companies that do not have the same objectives as the NHS. I have therefore tabled amendment 100, which would do for ICPs what my amendment 101 would do for ICBs: seek to ensure that they are made up wholly of representatives from public sector organisations, and that private companies are not represented on them.
The Bill will break up the NHS into 42 integrated care systems. My amendment 59 would ensure that any provider of health services could not withhold provision of those services from any individual because of the integrated care board to which they were allocated. In other words, wherever in England someone falls ill, they could get treated. There have been alarming recent reports of people in need of urgent care being turned away from A&E because they did not present at the A&E centre closest to where they live. That is  extraordinary—it is not what we expect of the national health service. One recent report told of a woman who suffered burns and attended A&E, only to be told that the hospital did not treat people from Rochdale. There is nothing in the Bill to ensure that people in the country can go to any A&E in the country if they need to. My amendment is designed to address that shortcoming.
As we know, the Bill is also about enabling privatisation—and when we look at the procurement reforms in it, we can see why. They will enable the removal of the current procurement rules that apply to NHS and public health service commissioners arranging clinical healthcare services. The Bill will provide a power to create a separate procurement regime for those services, including removing
“the procurement…of…health care services for the purposes of the health service”
from the scope of the Public Contracts Regulations 2015.

Diane Abbott: Does my hon. Friend agree that the Bill has the sense of being an NHS corporate takeover Bill? We have already seen £5 billion in contracts being awarded to private companies through the VIP lane. The Bill opens the door to private corporations sitting on 42 local health boards. That is wrong.

Margaret Greenwood: I thank my right hon. Friend for putting the case so clearly. She hits the nail absolutely on the head: as a result of the Bill, contracts could be handed out to the private sector without the stringent arrangements that one would expect in the awarding of public money. That is a recipe for the kind of cronyism that has become all too familiar, as she says.
I turn to the cap on care costs. I was proud to stand on a manifesto in 2019 that pledged to
“build a comprehensive National Care Service for England”,
to include
“free personal care, beginning with investments to ensure that older people have their personal care needs met, with the ambition to extend this provision to all working-age adults.”
The Conservative manifesto in 2019 did not go that far, but it at least made the guarantee that
“nobody needing care should be forced to sell their home to pay for it.”
We now know that that was a sham—another broken promise by this Government.
Last week, Ministers sneaked out changes to social care plans that would mean that poorer pensioners will not after all be able to count means-tested payments by the state for their care towards a total cap of £86,000 for any individual. The Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), described it as “deeply disappointing” that the new plans were “not as progressive” as those put forward by Andrew Dilnot, the economist who drew up the original plans for a cap on individual contributions. Mr Dilnot has said that the Government’s plan is
“a big change that…finds savings exclusively from the less well-off group.”
A former Conservative Cabinet Minister has urged the Government
“to adopt a different approach”,
while another Conservative MP, a former Under-Secretary of State for Health, has said that
“it will be poorer pensioners who have relatively modest assets that will be most affected by these changes.”
I hope that Members on the Government Benches are listening to those points from Government as well as Opposition Members and will do the right thing. Elderly people deserve better. All Members, including Government Members, have a responsibility to vote these measures down.
When the Prime Minister was discharged from hospital in April 2020, having spent seven nights there, of which three were in intensive care, he said that
“the NHS has saved my life, no question.”
Now he and his Government should save the NHS by withdrawing the Bill. The national health service is this country’s greatest social achievement. It is devastating that this Conservative Government are intent on taking it off us.

Matthew Hancock: I support new clause 49 because I support the action that is needed to make reforms to social care that are long overdue. I have listened carefully to the debate, and it is vital that we understand that the new clause would deliver one part, but not the whole, of the package that was set out by the Government in September. There is no doubt whatever that that package, as a whole, improves the provision of social care, makes the way it is paid for fairer, and removes some injustices that have existed in the system for far too long.
First, the proposal that has been put forward—and I think it is the right proposal—is for a cap on the costs that individuals face in paying for their care. The contributions from the state, even if they are from another part of the state such as local government, are not individuals’ care costs, and it is therefore wrong that they should be contributions towards the cap. The cap has the stated goal of being a cap on the cost of care to an individual, not a cap on the cost that accrues to both the individual and a local authority.
Let us look at what would happen if the new clause were not passed. The provision of care by local authorities is different in different areas, largely according to how well off those local authorities are. A richer council that pays more costs than the statutory minimum as set out in the Care Act 2014 would help local residents to meet the cap sooner than a poorer council that pays only the statutory minimum of care costs, and therefore people who live in poorer areas would take longer to reach the cap, so we would end up, in effect, with a postcode lottery cap meaning that people from poorer areas would tend to have to contribute more. That is wrong, and I am very glad that it is put right by the proposals that are before us today.
Secondly, for those with lower asset values, the rise in the floor in the means test is more important. It is the rise in that floor that makes this system fair. When the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), read out a long list of places with low asset values on average—places where house prices tend to be lower—he listed exactly the areas that will benefit most from the rise in the floor. [Interruption.] We can see what Labour Members are doing. [Interruption.] They are taking a narrow area,  and they are taking a specific detail, and they are ignoring all the parts of the package that benefit the people who will benefit from this package as a whole. [Interruption.]

Eleanor Laing: Order. We will not get anywhere if people shout. This is supposed to be a reasonable discussion.

Matthew Hancock: Thank you, Madam Deputy Speaker.
A further point that is being ignored by those who are trying to make a meal of this new clause is that the cutting of the daily cost offset is much more valuable to those on low incomes than any change in the cap, because the cap, by its nature, is there to protect assets, and those who do not have many assets gain far more benefit from the cut in the daily cost that would otherwise clock up their contributions to the cap much more slowly.
Taken together, these elements make up a package that is beneficial to those on low incomes. It helps to make the system fairer.
My final point on new clause 49 is this. For years and years—including the years when I was Secretary of State, and including the entire 13 years when Labour was in power—nobody fixed the problem of social care. This Government have come forward with a package, and if we pull apart one part of the package, there is a risk to the package as a whole. As Sir Andrew Dilnot said on the radio this morning,
“the whole package is a significant step forward”.
It is always easy in politics, and in life, to say, “I just accept the bits of the package that I like”—and, in the case of the Labour party, to say, “I accept the bits that are very expensive for taxpayers.” Instead, we must look at the package as a whole, which is funded, and which can be delivered, for the first time in several decades, because it hangs together. The Government have presented a whole package, and it is the best possible option in the fiscally constrained times in which we live.

Julian Lewis: I am sorry to be unhelpful to my right hon. Friend, but if this element is so integral to the overall package, why was it not brought forward right at the beginning?

Matthew Hancock: This part of the package was described in September, because it was made clear in September that the £86,000 cap was a cap on individual costs. It did not say then that that included the costs that local government may make on someone’s behalf. I think it is a strong Conservative principle that, when we say we are capping the costs that an individual pays, we do not include the costs that another part of the state should pay. I think that that was clear, and more details have now been set out. Most importantly, this is a package that takes things forward in a way that has not been achieved for decades.

Rob Roberts: I do not think anyone across the House would argue that the measures that have been put forward are a significant step forward from where we are. However, as my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) and my right hon.  Friend the Member for South West Surrey (Jeremy Hunt) mentioned earlier, they are not necessarily what we might have been led to expect. Would my right hon. Friend like to comment on that?

Matthew Hancock: I will happily comment on that. In the debate over the past few days, many people have been comparing the package put forward by the Government with the proposals from Sir Andrew Dilnot in 2014-15, but there is a reason those proposals were never enacted and never came into force. It is because they had a huge price tag, and there was no successful debate on how to pay for them. It has been easy to ask for social care reform for the past three decades, but until this Government did it, nobody had come forward with a plan for how to pay for it. We simply cannot magic things out of thin air. If we are a grown-up Government, we have to come forward with a grown-up package, which includes saying how it will be paid for. That is what has happened, and that is why this package hangs together. We should support this new clause, because it is part of that overall funded package.
I want to turn briefly to the measures on integrated care systems. The purpose of the ICSs is to have a more preventive, more flexible and less siloed approach than we have under the current clinical commissioning groups, without removing the grit in the oyster that is the purchaser-provider split and without upsetting the 1948 settlement involving local authorities doing social care and having a national NHS. Amendment 76 in particular contains a lot of suggestions that might seem tempting. There are people who have an important voice in the debate. The problem, as we have seen with existing legislation, is that if we put too much into statute, it is far harder to deliver high-quality services that are integrated on the ground. That is why the Government are right to resist putting too much detail into legislation. However, I do support the change proposed by the Government, which makes it clear that the purpose of ICSs is not to have private providers on the board. I can confirm that, as the Minister said, it never was. Mischievous rumours were put about, some of which have been repeated today, that that was the intention, and I am glad that the Government’s amendment puts that matter beyond doubt.
I am attracted to amendments 89 and 90 and, in another group, amendments 91 to 98 and amendment 23, tabled by my hon. Friend the Member for Broxbourne (Sir Charles Walker). I was going to say this before I knew that I would be sitting next to him in the debate today, and I hope that the Government will look on these amendments kindly. The parity of esteem between mental and physical health is incredibly important, and I commend the amendments to the House.

Several hon. Members: rose—

Eleanor Laing: Order. It will be obvious to the House that a lot of people wish to speak and that there are a lot of amendments still to be spoken to. We have only an hour left, so I am going to impose a time limit of four minutes immediately. I apologise to the hon. Member for Bootle (Peter Dowd) for not giving him notice that he would have only four minutes, but I am sure that he will manage.

Peter Dowd: My amendments 1 and 2 primarily relate to self-care. I acknowledge that self-care is recognised by care professionals as part of the healthcare process, but, like prevention, it should not be an afterthought—a concept that we think invaluable but that we never get around to fully including in our health ecosystem in the way we ought to.
Amendment 1 would ensure that
“everyday wellbeing, self-care for minor ailments and the management of long-term conditions”
are promoted and integrated into local health systems. As we learned during the first waves of the pandemic, those with minor ailments are best off seeking care within their local community, for example, by practising self-care or seeking advice from their local pharmacist to support them in their illness. There is nothing wrong with promoting self-care, but it must be as part of a wider, more comprehensive health system, where it is needed.
The health system has promoted self-care forever. It has always done so as part of the process. As integrated care systems become statutory organisations, primary care networks will continue to be an important conduit for improving self-care in the community. They provide an opportunity for the community pharmacy to be fully integrated into local primary care and improve communication across all primary healthcare providers. Promoting and integrating self-care across the self-care continuum, from everyday wellbeing to self-care for minor ailments and the management of long-term conditions, will help to empower people to know when and how to self-care, and in turn support more sustainable local health systems.
Amendment 2 focuses on how community pharmacists are well placed to drive a holistic approach to self-care. They can advise people on the most effective over-the-counter treatments, as well as on self-care techniques, for example, via the community pharmacist consultation service, which has been an important initial step in ensuring that the system is designed to support self-care for treatable conditions. The amendment would ensure that the strategies developed by integrated care partnerships take account of the benefits that services offered by pharmacists for minor ailments can provide, in turn helping to integrate these services into local care pathways.
During covid, many people decided not to go to GPs, and many continue to say they will not go to GPs, but will try to get support outside the GP system as part of that self-care process, as a couple of surveys have indicated. One of the questions they were asked was how they felt about getting advice online or from a pharmacist.
I reaffirm, if it were needed, that self-care is not about self-isolation from health care services. It is not about reducing the strain on the NHS by a sort of self-imposed rationing. It is about not diverting people away from healthcare, but rather providing another route into it. These amendments, at the very least, ask the Government to think on the need for a more structured approach to self-care that is there to help and benefit patients.
The question is whether this Bill, in the round, achieves a reboot of self-care in the light of covid. I am not sure it does, but I ask the Minister to consider carefully the process of self-care in a much more formalised way.

Caroline Dinenage: I rise to speak on new clause 49. For 40 years, successive Governments have tried desperately to address this issue, and successive Governments have put it in the “too difficult” pile. It is incredibly expensive, it is hellishly complicated and, to put it simply, there is no silver bullet to address all the concerns surrounding it. That is why I am so proud that this Government have made an attempt to grip this issue.
The fact is that what happens to us in old age is entirely random, and whether we incur catastrophic care costs that wipe out everything we have worked for in our lives is often down to luck. The current system is complex, it is unfair, many people simply do not understand it, and that has been compounded by the fact that successive Governments—nobody is blameless—have used unhelpful language such as “death tax” and “dementia tax”, which have made people terrified of the issue and blown any Government’s attempts to try to solve it out of the water.
Such language strikes fear into people’s hearts about what will happen to us when we are elderly, when we are vulnerable, when we cannot look after ourselves any more. As humans, this is something we do not want to talk about. We do not want to consider it or think about it happening to us; not for us the slow decay, the hellishly expensive degeneration, which affects perhaps four in 10, with the catastrophic amounts of money involved affecting perhaps one in seven. That is why insurance models have never really worked.
The new clause looks to amend the cap on care, basically, where the local authority costs should contribute to the metering towards the cap. I have to be honest: I thought really hard about whether I could support this. Many people, including the brilliant Andrew Dilnot, have pointed out the financial inequalities and some of the geographical inequalities of removing the local authority contribution. As local authority contributions differ by area already—they are much higher in better-off areas—there is already a postcode lottery of care depending on where someone lives. We have to address that. The key thing here is not the cap, but the floor. Those with lower property values will be protected by the floor, not the cap. The reforms increase the threshold above which people must meet the full cost of their care from £23,000 to £100,000—more than four times the limit. The daily living costs limit of £200 per week means that more people will keep more of their income and assets and the package includes domiciliary care, which many others have not done. It is not perfect—it is far from perfect—but everyone who is contributing towards their social care today, and those of us who face the uncertainty of this possible spectre in our future, will be better off than they are now. That is why we have to move forward in a way that is deliverable and that we can finally, for once, get over the finishing line, after 40 years of trying.
There are details that need to be fleshed out. The White Paper just cannot come soon enough and I wish to mention two burning issues in particular. The first is how we support working-age adults, who make up more than half of those who need adult social care. Some people need that care throughout their lives; for others it happens to them unexpectedly. How do we support the people of working age for whom care costs are not paid out of a nest egg, which they might have been able to build up over decades of work? Finally, the biggest  issue facing adult social care is the workforce. This job is significantly undervalued. It is too often described as “unskilled”. That drives me mad. These people have unbelievable skills. They have experience and passion, and we entrust our most valuable and precious family members into their care and their hands. Frequently, they just make more money in hospitality or retail. How do the Government create a society that values these heroes for what they are? I look forward to reading the White Paper and seeing how the Government will tackle some of these thorny issues, the most intransigent challenges facing our adult social care system, because for those money alone will not be enough.

Daisy Cooper: I would like to start by talking about social care. The Liberal Democrats have long called for reform to properly integrate health and social care services, but this Bill does not do that. As others have mentioned, it seeks to reorganise parts of the NHS, but it pays lip service only to social care. That is why the Lib Dems think that the Bill should be put on hold until the proper social care reforms are brought forward.
As others have mentioned, it has been months since the Prime Minister announced his plan to fix social care. It is unforgivable that this new clause was sneaked out during the sleaze row last week, in a move that changed the goalposts. The Minister would do well to listen to the unease among his Back Benchers as well as among Opposition Members.
Struggling families now face being hammered by a double whammy of unfair tax rises and the prospect of losing their homes to fund care costs. The right hon. Member for West Suffolk (Matt Hancock) is no longer in his place, but I noted that he selectively quoted Andrew Dilnot. He did not quote Andrew Dilnot’s comments on new clause 49. Andrew Dilnot said that that proposal was not welcome. He said that he was very disappointed and that this represented “a big change” that
“finds savings exclusively from the less well-off”.
That is two promises from this Tory Government now broken.
There is also no mention in this Bill of the millions of people who are unpaid carers in the UK, even though we know that carers are twice as likely to experience ill health as a result of caring. That is why I have tabled new clause 63 for debate tomorrow. It is supported by Carers UK and it calls for the NHS to ensure that the health and wellbeing of unpaid carers is taken into account when decisions are made concerning the health and care of the person for whom they care. I hope the Government will support it. I know it is grouped for debate tomorrow, but I reference it now to highlight again the fact that the Bill does not present a comprehensive plan to reform social care.
The Bill also represents a massive and unnecessary power grab by the Secretary of State. It is simply wrong for the Government to have the power to abolish arm’s length bodies and approve or reject the chairs of integrated care systems. The public have been rightly outraged at political meddling in covid contracts, and the Government should learn their lesson. We should all be seeking to protect the independence of the NHS.
Vacancies in the NHS and social care are utterly staggering. We know the numbers: 100,000 vacancies in the NHS and more than 120,000 in social care; and 1.5 million people missing out on the care they need. We simply cannot go on like this, with the Government setting their own sporadic targets and constantly missing them. NHS waiting lists are at a record high. Ambulance services received a record number of calls in October. Major A&Es treated more than 1.4 million people in October—the third highest monthly figure on record.
The Bill will do nothing to get those waiting lists down, nothing to recruit the workforce we need, nothing to help people get seen faster and nothing for the millions of unpaid carers. The Government should delay the Bill for a few months and look properly at reforming social care, rather than doing a half-baked job now. But I do not think they will, and that is why the Lib Dems will vote against it.

Maria Miller: I listened carefully to my hon. Friend the Minister for Health earlier as he introduced new clause 49 because the funding of social care has been a huge concern for too many years. The people we represent deserve far more certainty about how their old age will be funded if they require social care.
We have a pension system and a system to support disabled people, but the funding of social care is a real uncertainty. I pay tribute to the Minister for bringing forward these costed proposals to provide some certainty for the future for more people. He is to be commended for being clear that no one will lose out under the proposals and that the majority will be better off because of the issues that we have already gone through—particularly because the means-test threshold is being significantly raised. He can say that with some force because of the more than £5 billion extra being put forward by the Government to fund social care in a sustainable way for the future.
However, there is still clearly some concern, as the Minister can hear from the debate. As my hon. Friend the Member for Gosport (Caroline Dinenage) said, no solution will be perfect, so I was particularly pleased to hear of the Minister’s plans to publish an impact assessment, which will clearly set out the impact of these measures across the board. That is important.
Finally, I want to speak in support of my amendment 102. We all know that the quality of support that we give victims of domestic and sexual abuse is a marker for the health of our society, and it is not just a matter for the NHS. However, the NHS plays a vital part in that support. Amendment 102 requires the joint forward plan for integrated care boards and their partners to properly set out the steps they propose to take to address the needs of victims of domestic abuse—whether domestic violence or sexual abuse, and whether it involves children or adults.
Amendment 102 does not limit the plan to addressing only the victims of domestic abuse; many other types of abuse are equally devastating, and it is permissive enough to allow innovation and improved ways of working to be developed in guidance. I hope that it can be used as a basis for guidance to integrated care boards as part of their general powers.
Amendment 102 is just part of the greater whole. The Police, Crime, Sentencing and Courts Bill in particular will require action across Government, but the amendment will help to ensure that every part of the state is pulling in the same direction when it comes to issues of domestic and sexual abuse. My amendment is similar to new clause 33, which my hon. Friend the Member for Newton Abbot (Anne Marie Morris) outlined earlier, but my amendment is more permissive and less prescriptive, so I hope the Government will find it acceptable.

Edward Argar: I am grateful to my right hon. Friend for the case she is making. I should also put on the record my gratitude for the work that my hon. Friend the Member for Newton Abbot (Anne Marie Morris) has done in this policy space and for her proposal. Her Majesty’s Government are happy to accept my right hon. Friend’s amendment 102 on support for victims of domestic abuse.

Maria Miller: I thank the Minister for his acceptance of my amendment. Many people in all parts of the House will see it as a continuation of this Government’s commitment to tackling the issues of domestic abuse and sexual abuse. I thank him for such a positive acceptance.

Bell Ribeiro-Addy: I rise to speak against the Bill overall but in favour of new clauses 56 and 57, tabled in my name, and those amendments and new clauses tabled by any Member who has sought to change the pernicious outcomes of the Bill.
Our NHS is really one of the best things about this country, but the Bill is the biggest threat to it yet. It rolls out the red carpet for private companies, ramps up the Government’s long-standing attempts to privatise the NHS, and makes easier what we have witnessed over the past 18 months: the awarding of contract after contract without a competitive process, and the rewarding of failing companies with new contracts again and again.
The Bill will be the destruction of our NHS as we know it, and will widen the inequalities that the pandemic has exacerbated. We now have more than 5.7 million people on NHS waiting lists. Of course, that is not solely because of the pandemic—far from it. After the Government won the 2010 election, around 500,000 to 750,000 people were on NHS waiting lists, and the number rose every year before the pandemic, so the waiting lists are the long-term effect of the Conservative policies of underfunding and privatisation.
Waiting lists have now doubled, and our NHS is in danger of toppling over. All the while, health inequality is rising. That is why, with the support of the Health Foundation, I tabled new clause 57, which would compel the NHS to set out data-collection guidelines on health inequalities. We know that health inequalities exist and have seen them play out with the worst consequences, from postcode lotteries to racial disparities, and it is time that we accepted that, collected the proper data—it is a farce that we do not already do so—and set out to make real change.
Since 2010, improvements in life expectancy in England have slowed more than in any other country in Europe, and the gap between rich and poor in respect of the  number of years people can expect to live in good health has widened even further. During the pandemic, that was shown by the higher death rates among people who live in more deprived areas and among certain populations, most notably disabled people and people from black, Asian and minority ethnic communities. Among people younger than 65, the covid-19 mortality rate was almost four times higher for the 10% living in the most-deprived areas than for those living in the least-deprived areas. This is nothing new; the Marmot reviews have covered that many times.
Earlier this year, the King’s Fund found for the NHS Race and Health Observatory that any success we have in tackling health inequalities is always drowned out by other strains, such as waiting times and other clinical priorities. Put quite simply, we cannot tackle inequalities because this Government have never put equality at the front and centre of their policy making. That makes their so-called levelling-up agenda meaningless.
The Bill will enshrine in law the new so-called triple aim to promote various different factors, but the Government are so short-sighted that they have declined to incorporate health inequalities into the triple aim. What a complete missed opportunity that is—or a clear indication that the Government really could not care less. Before anybody says any different, and that the NHS has other means of doing that, we need to look at the state of the outcomes, because what is happening is clearly not working.
The Government continuously and repeatedly fail to accept examples of institutional discrimination, let alone meet their duties under equalities law. We recently heard about how the issues in respect of oximeters and dark skin will have contributed to worse outcomes. The Secretary of State for Health and Social Care has called for a review of gender and race bias in medical equipment; quite frankly, that is groundbreaking—all we seem to do is have reviews. We would already have these types of policies had we just heeded past Government reviews and looked at the equality impact assessments. There is no excuse for the Government to keep ignoring the requirement that is already set out in law for them to meet their equalities duties to people right across this country.

Charles Walker: I caught your eye half a minute ago, Madam Deputy Speaker, and you indicated to me with that look that I was next. My heart rate quickened. I am always nervous when I speak in this place because we do really important stuff here—all of us do—and this is an important Bill.
Before the Health and Social Care Bill became an Act in 2012, it was amended by the Conservative Government. It was amended in pursuit of parity of esteem. The Coalition Government changed general references to health to “physical health and mental health”, which was not a courageous thing to do—it was entirely the right thing to do.
I have tabled a series of amendments—10, if I have counted them correctly—for debate over the next two days. They ask the Government to change all general references to health to “mental health and physical health”. It is a call to arms. These changes are not just totemic, but hugely important. Over the next few years, we need to recruit 9,000 more mental health nurses to   look after our constituents and more than 800 new psychiatrists, and we need to give all organisations charged with delivering healthcare that nudge, that push, that call to arms that they need to make these important things happen. We also need to send another message from this place—on top of all the other messages that we have sent over the past nine years—that we believe that there is no physical health without good mental health, and that good mental health means good physical health.
I am looking at the Minister because he has made a couple of staggering interventions on colleagues tonight. Colleagues in full flow, prostrating themselves at the feet of Government, have suddenly been rewarded with his stylish, charming intervention of, “The Government have heard your cries, and they shall act on them.” I looked at the joy that spread across the face of my right hon. Friend the Member for Basingstoke (Mrs Miller), and across the face of my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, who spoke before me. I look at the support I have from my right hon. Friend the Member for West Suffolk (Matt Hancock), the most recent former Secretary of State—there are a few of them—and from a former Prime Minister. May I ask the Minister to make one of those generous interventions on me this evening? I am still here. I want to sit down, but if he is not going to make that generous intervention right now, I shall be back tomorrow. I shall also be travelling up to the other place and knocking on its door to make sure that these amendments are tabled there, so that, eventually, we get our way.

Karin Smyth: I came to this place largely on the back of the disastrous Lansley Act, and I am pleased to see it banished to the dustbin of history, which is what this Bill essentially does. It also banishes to the academic shelves that example of how not to make policy. Lansley took a sledgehammer to our work in primary care trusts, to partnerships, to morale, and to our capacity to forward-plan. Along with the austerity funding that came with it, the Act directly led to the poor state in which we entered the pandemic, and that must be front and centre of any review of the pandemic.
This Bill is a seminal point in the history of the NHS, because it banishes again to the history books experimental competition as an organising principle and a driver of efficiency. The key issue is what replaces it. Now we have in its place local cartels dominated by hospital trusts, and the supreme power of the Secretary of State to interfere in all local decisions. There is no power here for local elected representatives, no power for primary care or community care or mental health, no voice for patients, no voice for the public, and no voice for the taxpayer, who is asked to pay ever more. As we move to an ever more costly health service, accountability and transparency of our NHS in this role has to be at front and centre in order to bring people with us on that journey of paying more.
I have tabled two amendments to this part of the Bill. One is on the need for the local boards to be cognisant of palliative and end-of-life care. The other is on local improvement finance trusts, the local public private sector bodies introduced under the last Labour Government  that are instrumental in providing good primary and community care estate—something that this Government are allowing to wither on the vine. My own South Bristol Community Hospital needs more support through these trusts in order to thrive, so that people have decent, good-quality estate from which to receive their care.
I also draw hon. Members’ attention to my new clause 23 on a good governance commission, which will be discussed tomorrow. I genuinely offer it as a helpful way forward. If it were enacted by the Government, it would avoid the cronyism that we have become used to, and would ensure that local bodies are more democratically accountable to their populations and more cognisant of the needs of their local populations. It would ensure that the people leading the local bodies are fit and proper, meet basic criteria regarding what is expected of them and have crucial accountability to local populations. It is akin to the Appointments Commission, which was abolished in the abolition of the quangos; that was a huge mistake. If the Government took notice of it, the new clause would really help us to get around some of the real concerns about how our local health services are governed.
Let me finally address new clause 49 on social care. It is a disappointment and unexpected. We had six weeks in Committee. In that time, we could have looked carefully at the proposal and shone a bit of light on it. The right hon. Member for West Suffolk (Matt Hancock), who is no longer in his place, clearly tried to say what this provision is really about, in that one part of the state should not be subsidising another part of the state. He started to say that that was a true Conservative principle and he was absolutely right. This provision will remind people who are in receipt of benefits that they are in receipt of those benefits, and that anything they may have built up should not be counted towards their future. It is a punitive property tax. I am old enough to remember what happened to the last Conservative Government who introduced a regressive property tax; this Government really ought to think again.

David Simmonds: I draw the attention of the House to my entry in the Register of Members’ Financial Interests in that I am married to an NHS doctor, who is employed by a hospital trust that serves my constituency.
Let me turn first to new clause 49. Those of us who have been in the world of local government for a long time will have seen the attempts by Governments of various parties to address the financial settlement around social care. I chaired a social services committee that pushed through the charging policies introduced by the last Labour Government in an attempt to address these costs. I also chaired a social services committee that had to balance the demands of the fair access criteria, and saw the last Labour Government drive a coach and horses through a lot of local provision.
I recognise that we should all seek to ask questions of Governments about how we address in particular the impact on working-age adults. In response to the people asking whether we are proud of what we are here to do tonight, I would say that we should be proud of the fact that we are willing to take what are sometimes difficult decisions to ensure that we balance the books and  have a sustainable financial settlement that supports  social care for our constituents. It is too late for my two grandparents, who went through the process and saw very modest assets consumed by the cost of long-term care, but I welcome the fact that my constituents, and people up and down the country, will benefit from what this Government are seeking to achieve.
I will move on, briefly, to new clause 55, which addresses the responsibilities for ICSs regarding the provision of services and planning for services for our youngest children. My right hon. Friend the Member for South West Surrey (Jeremy Hunt) made a helpful intervention, in which he pointed out the effectiveness of Ofsted-style regulation in ensuring the quality of provision at a local level.
We had an excellent debate in the Chamber just a few weeks ago, discussing the work done by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), which was reflected in the budgetary decisions that were brought forward previously. Having had that debate, it seems clear to me that in tabling an amendment supported by more than 70 organisations in the field of children’s care, we have an opportunity—one which was debated and touched on through various assurances from Ministers in Committee. It is an opportunity to ensure the right level of rigour and accountability in what we ask of ICSs, so that we can make sure that our youngest children, babies, neonatal care, and indeed young people up to the age of 25 who are already covered by statutory provisions in respect of special educational needs and care leaving, are appropriately covered.

Several hon. Members: rose—

Eleanor Laing: I am going to reduce the time limit to three minutes in the hope that as many people as possible can get in.

Richard Burgon: The Health and Care Bill is deeply problematic. I want to focus on two issues that, when combined, mean that it is a complete disaster. It not only makes it easier for private health giants to profit from the national health service; it also makes a charter for corruption because it opens the door to even greater private sector involvement in our NHS. That is why this Bill should really be called the NHS corporate takeover Bill. For example, it allows private corporations to sit on health boards, which make critical decisions about NHS budgets and services, and the Government’s amendment 25 does not go nearly far enough.
Even before this Bill, an unbelievable £100 billion has gone to non-NHS providers of healthcare over the past decade alone, and earlier this year half a million patients have had their GP services quietly passed into the hands of a US health insurance giant. This Bill would lock in yet more privatisation in future, with even less scrutiny, because it means less transparency. It means private health giants getting an even bigger slice of the action with less scrutiny.

Daniel Poulter: I draw the House’s attention to my declaration in the Register of Members’ Financial Interests as a practising NHS doctor. On the issue of private healthcare provision, the hon. Gentleman will recognise that GPs  are in fact small businesses in their own right, and some of them quite large businesses. How does he equate the role of the GP as a small business in the context of his concerns about private healthcare?

Richard Burgon: We are not seeking to wage war on GPs; we want to support GPs and properly resource them. We see so many GPs retiring and not being replaced. It is this Government who are waging war on our NHS with this further Americanisation of our NHS. It is a dangerous cocktail where the dodgy contracts we have seen throughout covid risk becoming the norm. The billions squandered on test and trace should serve as a warning of what the Government could do to the whole of our NHS.
There is a sleight of hand going on with this Bill. It is true that under the Bill NHS bodies will no longer have to put services out to competitive tender to the private sector. Such tendering to the private sector was made a requirement under section 75 of the coalition Government’s Health and Social Care Act 2012. It was a shameful Act and its scrapping has long been demanded by those opposed to privatisation of our national health service. However, the change in this Bill does not reverse privatisation, because without making the NHS the default provider, that simply means that contracts can not only still go to private healthcare corporations but can do so without other bids having to have been considered.
To prevent all this, I tabled amendment 9, which I want to put to a vote—unless of course the Government accept it—because it establishes the NHS as the default option. [Interruption.] Conservative Members groan, but the only reason for people not to support my amendment is if they do not believe in the NHS not moving to a privatised insurance model. Why else would people object to the NHS being the default provider of healthcare? The British Medical Association supports it, so the Tory groans are groans against the position of the British Medical Association. Unison supports it, so the Tory groans are groans against the voices of those who work in the NHS—for most of whom, if they need to have more than one job, it is because they do not get paid enough, not because they are trying to get their own snouts in the trough. I will be voting against the whole Bill, but if the Government refuse to accept amendment 9 to make the NHS the default provider, that shows what the Government of the party that objected to the foundation of the NHS in the first place are really up to, despite all the warm words.

Mel Stride: I rise to speak to new clause 49. In doing so, and whatever its merits or otherwise, it is worth reflecting on the comments made by the Minister that we are at least here this evening looking at a part of a process that will lead to some progress in meeting social care costs going forward and removing the catastrophic risk that has hung above the heads of all our constituents up and down the country: that their healthcare costs may end up costing them all of their assets. We are also here having taken the tough decisions around having raised taxes to fund those arrangements.
I have problems with new clause 49. It seems to me that to make good law in this place, first, we need time to consider the matters put before us and secondly, we need the appropriate information upon which to take  those decisions. On both those points, I have real concerns about how new clause 49 has been brought forward. The first we heard of it was not in Committee or in September when the general measures were put forward, including the taxation measures on which we all divided and voted, but on Wednesday evening, when the amendment was tabled.
It was fortuitous that the Treasury Committee happened to have Sir Andrew Dilnot before us the very next day. We were able to discuss many of the issues inherent in new clause 49. A number of issues were raised, to which only the Government have the answers. One of them has been put forward powerfully by speaker after speaker tonight, which is: what are the impact assessments associated with these measures? I wrote to the Chancellor immediately after that session and asked him for some impact assessments, including geographical impact assessments, of which we have had none.
It seems that the only information we have had was released by the Department of Health and Social Care on Friday night, in a document called “Adult social care charging reform: analysis”. I am very short of time, which is a shame, but there is, for example, a chart of a 10-year care journey that looks at individuals with different asset levels. While it is true, as my hon. Friend the Minister said, that these arrangements, even with new clause 49, are better for almost every level of wealth than under the status quo, it is not the case that everybody is better off compared with the measures brought forward in September.

Alison McGovern: The right hon. Gentleman gets to the heart of the matter, which is what people will get, compared with what they were promised. Is that not the heart of this matter?

Mel Stride: I think the heart of the matter is that we have to be clear and wide-eyed about what this change will do. Yes, it is true that it will leave us in a better position than the status quo, but it is not the case that it will leave those who are less well-off in a better position than if new clause 49 were not passed by the House. For those with assets of about £106,000, by my read of this graph, about 59% of their assets would be lost on average under the original proposals. Under the amended proposals, that figure would rise to 70%. When it comes to those who would be better off as a consequence of new clause 49, many are the better off, because they benefit from the changes being made to daily living costs, to which my hon. Friend the Minister referred.
I am out of time, but I believe that these measures should have been better ventilated in this House—certainly in Committee, if not earlier. We would then have had better information and more time in which to make these important judgments.

Diana R. Johnson: I want to speak briefly to amendment 15, which focuses on the membership of integrated care partnerships—the bodies that will be responsible for developing plans to address the health and care needs of local populations. The amendment would enable the Secretary of State to make specific provisions ensuring  the representation of particular areas of healthcare on ICPs via secondary legislation.
In particular, I am concerned about having a strong voice for women’s health in ICPs. I also mention in passing the need for other groups to be represented, such as carers, in an ICP area. As co-chair of the all-party parliamentary group on sexual and reproductive health, I have seen how the experience of women in relation to their healthcare is often an afterthought in a fragmented health system, as in the case of the vaginal mesh scandal; the recent debate about pain during the insertion of intrauterine devices, a form of contraception; maternity provision; and cuts to contraceptive services.
The amendment would ensure that the issue of representation was considered by the Government. It has strong support from the medical bodies in this area, including the Faculty of Sexual and Reproductive Healthcare and the Royal College of Obstetricians and Gynaecologists, as well as in other areas of healthcare, such as childhood cancer, and, as previously mentioned, carers groups.
It is important to protect the independence of ICPs and ensure that they can set a strategy that effectively meets local needs, but there is also a need to ensure that women’s voices are not left behind in the decision making. Without this amendment, it cannot be assumed that those voices will be heard on all ICPs. I hope that the Government will consider the purpose of the amendment, which is to strengthen the Bill.

Theresa Villiers: There is much to be positive about in relation to the recent history of the national health service. NHS England research indicates that the outcomes for most major conditions are significantly better than they were 10 years ago, and the NHS is seeing more patients and delivering more tests, treatments and operations than at any time in its 73-year history—millions more than 10 years ago when the Conservatives returned to power.
To reassure those concerned by some of the campaigns around the Bill, I emphasise that this Conservative Government are committed to NHS values. We are delivering the biggest ever cash increase in NHS funding. It is just plain wrong to accuse the Government of trying to privatise the NHS. In fact, it was the last Labour Government who pushed competition and private sector involvement, including many private finance initiative contracts that proved to be unwise and massively expensive. If anything, the Bill takes the NHS in the other direction by reducing the role for competition and increasing the scope for co-operation.
At the Bill’s core are the integrated care systems considered by this group of amendments. Its provisions on ICSs enjoy considerable support from within the NHS and build on the NHS’s own proposals for reform to make it less bureaucratic and more accountable and to enable it to be more integrated with other local service providers, such as councils.
I will not be backing the amendments in this group except those tabled by the Government. I welcome Government amendment 25 for the clarity that it provides to ensure that appointments to ICBs will not in any way jeopardise their independence. By dismantling elements of the complex system for compulsory tendering of  services, we will free up time and resources in the NHS and remove barriers to local co-operation so that we can improve patient care.
We all recognise that ever-increasing healthcare needs place great pressure on the NHS, which will rise in years to come as more of us become frail and need extra care. I ask the Minister, in his response, to emphasise how we will train, recruit and retain the professionals we need to deliver NHS services. Record numbers of doctors and nurses are working in our NHS, and I pay tribute to each and every one, but it is crucial to step up the numbers, especially of GPs. GPs in my constituency are overstretched and we need more of them. That needs to be a priority for the Government.

Several hon. Members: rose—

Eleanor Laing: Members will appreciate that I have had to give precedence to people who have amendments in their names on the Order Paper, so not everyone else will have a chance to speak this evening.

Apsana Begum: In the interests of time, I will just speak to my amendment 99 and new clause 57 tabled by my hon. Friend the Member for Streatham (Bell Ribeiro-Addy).
The Government often talk the talk on health inequalities but fail to walk the walk. New clause 57 sets out a requirement that NHS England must publish guidance in relation to health inequalities, which I wholeheartedly support. My amendment 99 seeks to put in provisions to reduce inequalities between non-migrant and migrant users of health services. Campaigners and experts have argued that the pandemic has shown more tangible action is needed to tackle health inequalities. The increased risks of those on lower incomes and black, Asian and minority ethnic communities catching and dying from covid-19 have been well documented, yet the provisions outlined in the Bill will likely make the situation much worse.
I tabled amendment 99 in particular after seeing evidence that people are being denied access to healthcare, or are facing high charges for doing so because of their immigration status. As part of the hostile environment, the Government have increasingly been restricting access to the NHS for certain migrants by introducing upfront charging for those unable to prove their entitlement to care, by charging migrants for the cost of treatment and by sharing NHS patient data with the Home Office for the purposes of immigration control.
Surely, in any civilised society, migrants should have automatic access to services without fear of detention or deportation, and without facing barriers that deny them their rights. Everyone being entitled to treatment goes to the core of what the NHS is, and why it is valued and beloved. Access to high-quality healthcare is possible for all, and this can be done best when healthcare provision is publicly run, publicly accessible and publicly accountable. My constituents deserve nothing less, and I will never stop pursuing this goal until it becomes  a reality.

Andrea Leadsom: This Bill can really help support giving every baby the best start for life.
First, new clause 55, in the name of my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds), would require the Secretary of State to publish guidance on how integrated care systems should meet the needs specifically of babies. “The Best Start for Life” report, published in March, calls for every local area to publish a seamless start for life offer for every new family. That must include midwifery, health visiting, mental health support and targeted services such as couple counselling, debt advice and smoking cessation. Each of these services is currently provided from silos within the public, private and civic sectors, so properly integrating them is no small task. I urge my hon. Friend the Minister to ensure there is very clear guidance to every local area on how it should co-ordinate its support for babies.
I also want to support amendments 91 and 92, in the name of my hon. Friend the Member for Broxbourne (Sir Charles Walker), which call for parity of esteem between mental and physical health. Mental health support for families who are struggling in that critical early period is vital. The London School of Economics has assessed that perinatal depression, anxiety and psychosis carry a total long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK. Prevention is not only kinder but so much cheaper than cure.
Finally, I would like to support amendment 102, from my right hon. Friend the Member for Basingstoke (Mrs Miller), which calls for integrated care boards to provide clarity about their plans to tackle domestic violence. I am delighted that the Minister has already agreed to accept it. Analysis by the WAVE Trust indicates that up to 30% of domestic violence begins during pregnancy. The WAVE Trust highlights the crucial nature of experiences in the period of conception to the age of three in the formation of seriously violent personalities, largely because of the sensitive nature of the infant brain in those formative years. Domestic violence within a family is incredibly damaging to the emotional development of a baby, and I encourage my hon. Friend the Minister to ensure that plans for tackling domestic violence cover not just relations between partners, but reducing the impact on babies.
Madam Deputy Speaker, you may have heard me speak in this place before about giving every baby the best start for life, and I keep doing so because I am convinced that, if we invest in the 1,001 critical days, we really will transform our society for the better. It is in the period from conception to the age of two that the building blocks for lifelong physical and emotional health are laid down.

Jess Phillips: I was not expecting to be called, Madam Deputy Speaker, but here we are. I want to tell a little story about my dad. My dad often rings me and tells me the things I should say in Parliament—I am not entirely sure any of you are quite ready for it, but I want to tell a story about my dad. He was born in the war, and they were given a council house by the Attlee Government—my dad could lecture us on it for weeks! He was given a council house, which his very Conservative parents bought in the 1980s. My granny, unbelievably—a lovely, generous woman—was  a massive Thatcherite. She bought her council house in the 1980s, and that council house stands in my constituency. It is worth around £120,000.
My dad went on to get an education—a free education—and he moved into an area of Birmingham that was not very trendy at the time. He stayed there, I was born there, and my brothers lived there. All through our lives we watched that area get a little bit trendier, and the price of my dad’s house, which he bought for £30,000, went up and up and up. He didn’t particularly do much work—he likes to woodwork in his garage, but he has not done much. His house is probably worth around £700,000 now, and it was £30,000 when he bought it.
If my dad were here today, what he would say to hon. Members, and what he will almost certainly say to me, because he watches it all, lurking on Twitter, is that he does not deserve to keep his wealth for his children at any greater rate than the people who live in the council house that his parents bought on Frodesley Road in Sheldon. Yet today, the people who live in my constituency and the council house that my granny bought, to try to get a better life, will subsidise the care of my father, who has a £700,000 house that I do not need to inherit. I’m all right. I’ve got quite a good job. It is totally unacceptable that that is the situation we are putting almost all my constituents in, compared with constituents in Chipping Norton, for example, or the constituents of other hon. Members who have stood up and spoken. My constituents will largely be left with nothing. They will not be grateful.

Edward Argar: I am conscious of time, Madam Deputy Speaker, so I will try to cover some of the main themes that have emerged from today’s debate. I am grateful for the debate we have had today. The vast majority of what is contained in the Bill is exactly what the NHS said that it wanted and needed, and it is the right legislation being brought forward at the right time, to drive forward those priorities highlighted by the NHS in its 2019 consultation. The Bill drives forward integration not only within the local NHS within a region, but also greater integration with a local authority. It provides the foundations on which we can continue to build, as we move forward with greater integration of health and social care services that are designed to work around the individual, rather than in institutional silos.
Despite misleading claims by campaigners—and, indeed, by some Opposition Members—the Bill does not privatise the NHS. The NHS will always be free at the point of delivery. It has been in the hands of the Conservative party longer than it has been in the hands of any other party, and the Conservative party has put in place record investment in terms of resources in our NHS. What we propose in the Bill continues to build on that. Government Amendment 25 on ICBs is clear: ICBs are NHS bodies. They have always been NHS bodies in our proposals, and we have put in place provisions regarding conflicts of interest. Just to make sure, and given the misleading claims about private involvement, new clause 25 puts beyond doubt that ICBs are NHS bodies and must act in the best interests of the NHS. It is an amendment that is much stronger and much more effectively drafted than the alternatives put forward by the Opposition, because we believe in putting this question beyond doubt.
On the ICBs and ICPs, we have sought to be permissive rather than prescriptive, giving those local systems, within a national framework, the flexibility to deliver what they need to deliver for their local areas, which they know best.
I have been happy to accept amendments 102 and 114. I will continue to reflect on the points made by my hon. Friend the Member for Broxbourne (Sir Charles Walker); in the nicest possible way, I suspect that—rightly—he will not go away. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), set out very clearly the case for his amendment 114, which I was happy to accept, and the importance it places on patient safety.
My right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) has done a huge amount of work in this space—I pay tribute to her—and she is right: we will look very carefully in the statutory guidance at how we can emphasise that. I fear that my hon. Friend the Member for Newton Abbot (Anne Marie Morris) was not in her seat when I paid tribute to the work that she had done previously, but I put that on the record too.
On new clause 49, my hon. Friend the Member for Gosport (Caroline Dinenage), a distinguished former Care Minister, made the point extremely well that this is a significant improvement and step forward on where we currently are in respect of tackling the social care challenge.

Kevin Hollinrake: Will the Minister give way?

Matt Western: Will the Minister give way?

Edward Argar: I am afraid I will not, because I have only a couple of minutes in which to try to address these points, and I did give way a dozen or so times in my opening remarks.
Equally, I recognise, as always in this House, the strength and genuine sincerity of the views and the points put by hon. Members on both sides, genuinely highlighting and wishing to explore certain aspects of new clause 49 to understand exactly what it does and how it works. I have complete respect for the strength of those views.
I believe that, as my right hon. Friend the Member for West Suffolk (Matt Hancock) set out very clearly, this is a significant step forward. It will make a huge difference, and it must be treated as part of a package of measures rather than in isolation. As he quite rightly highlighted, we must look at the floors as well as the cap, at the support that is available, and at the increases in those floors from £14,250 to £20,000 and up to £100,000.

Matt Western: Will the Minister give way?

Edward Argar: I am afraid I will not, because I literally have only one minute, and I did give way multiple times in my opening remarks.
I believe that the measures in this Bill, which we have debated with these amendments today, give the NHS what it needs to further integrate to deliver the local services it needs and, crucially, move us a huge step forward in tackling the challenge posed by social care for future generations.
Question put, That the clause be read a Second time.

The House divided: Ayes 272, Noes 246.
Question accordingly agreed to.
New clause 49 read a Second time, and added to the Bill.
Proceedings interrupted (Programme Order, this day).
The Deputy Speaker put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83E).

Eleanor Laing: Amendment 102 has been selected for separate decision. I call Mrs Maria Miller to move the amendment formally.
The right hon. Lady is not here, but I understand that the Minister can move the amendment formally.

Clause 19 - General functions

Amendment made: 102,in page21,line25, at end insert—
“(c) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).”—(Edward Argar.)
This amendment requires the joint forward plan for an integrated care board and its partners to set out any steps it proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).

Eleanor Laing: There is great excitement on the other side of the House, but there is no doubt about the procedure. As the Minister had already indicated his intention to accept amendment 102, it was perfectly in order for him to move it.

Clause 25 - Care Quality Commission reviews etc of integrated care system

Amendment made: 114, page 37, line 27, at end insert—
“(2A) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.”—(Jeremy Hunt.)
The Secretary of State has the function of setting priorities for the Care Quality Commission in carrying out assessments in relation to integrated care systems. This amendment requires the Secretary of State to set priorities relating to certain matters.

Clause 69 - Procurement regulations

Amendment proposed: 72, in page 64, line 1, at end insert—
“(3A) The regulations must make provision in relation to the procurement of the services referred to in paragraph (1)(a) (other than primary medical services, primary dental services and primary ophthalmology services) that before any contract for a service with an annual value in excess of £5m may be awarded to an organisation that is not an NHS trust or NHS foundation trust—
(a) the business case for the award of the contract must be published;
(b) any responses to the proposal in the business case must be considered and published;
(c) the process for awarding the contract must be open and transparent and non-discriminatory at every stage, including (but not limited to)—
(i) procurement strategy and plan,
(ii) invitation to tender,
(iii) responses to invitations,
(iv) evaluation of tenders,
(v) decision to award, and
(vi) contract awarded;
(d) the process for awarding the contract must demonstrate due regard to the principles established in the Public Contracts Regulations 2015 (S.I.2015/102) or any regulations which may supersede them;
(e) in any case where it is claimed that an emergency justifies an award without the process being used then the responsible body must within 14 days publish the business case for the award of the contract and the record of the decision.”—(Justin Madders.)
Question put, That the amendment be made.

The House divided: Ayes 195, Noes 302.
Question accordingly negatived.

Schedule 2 - Integrated care boards: constitution etc

Amendments made: 25, page 125, line 26, at end insert—
“3A The constitution must prohibit a person from appointing someone as a member (“the candidate”) if they consider that the appointment could reasonably be regarded as undermining the independence of the health service because of the candidate’s involvement with the private healthcare sector or otherwise.”
This amendment prevents the appointment of a member of an integrated care board if they could reasonably be regarded as undermining the independence of the NHS because of their involvement in the private healthcare sector or otherwise.
Amendment 26, page 126, line 14, at beginning insert “at least”.
This amendment makes it clear that the constitution of an ICB may provide for more than one member to be nominated by NHS trusts and NHS foundation trusts.
Amendment 27, page 126, line 19, at beginning insert “at least”.
This amendment makes it clear that the constitution of an ICB may provide for more than one member to be nominated by primary medical service providers.
Amendment 28, page 126, line 24, at beginning insert “at least”.—(Edward Argar.)
This amendment makes it clear that the constitution of an ICB may provide for more than one member to be nominated by local authorities.

Schedule 2 - Integrated care boards: constitution etc

Amendment proposed: 78,page126,line26, at end insert—
‘(2A) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to NHS decision-making boards, integrated care boards, or any place-based committee or sub-committee of the boards.”—(Justin Madders.)
Question put, That the amendment be made.

The House divided: Ayes 192, Noes 300.
Question accordingly negatived.

Schedule 3 - Conferral of Primary Care Functions on Integrated Care Boards Etc

Amendment made: 29,page143,line31, at end insert—
“Health and Social Care (Community Health and Standards) Act 2003
47A In section 150 of the Health and Social Care (Community Health and Standards) Act 2003 (liability to pay NHS charges), in subsection (7)(d), for “99” substitute “99A”.” .—(Edward Argar.)
This amendment is consequential on the amendments made to Part 5 of the National Health Service Act 2006 by Part 1 of Schedule 3 to the Bill. It ensures that primary dental services provided by virtue of the provisions in Part 5 of the National Health Service Act 2006 will continue to be excluded from the definition of “NHS treatment” in section 150 of the Health and Social Care (Community Health and Standards) Act 2003.

Schedule 4 - Integrated Care System: Minor and Consequential Amendments

Amendment made: 30,page173,line29, at end insert—
“Network and Information Systems Regulations 2018 (S.I. 2018/506)
233A The Network and Information Systems Regulations 2018 are amended as follows.
233B In regulation 1(2) (interpretation), in the definition of “OES”, after “regulation 8(1)” insert “or (2A)”.
233C (1) Regulation 8 (identification of operators of essential services) is amended as follows.
(2) After paragraph (2) insert—
“(2A) Each integrated care board is deemed to be designated as an OES for the healthcare settings subsector and, in relation to an integrated care board, any services provided by it (including the making of arrangements for the provision of services by others) are deemed to be essential services.”
(3) In paragraph (8), after “paragraph (1)” insert “or (2A)”.” .—(Edward Argar.)
This amendment ensures that the Network and Information Systems Regulations 2018 apply to integrated care boards.
Bill to be further considered tomorrow.

Business without Debate

Delegated Legislation

Eleanor Laing: With the leave of the House, we shall take motions 3 and 4 together.
Motion made, and Question put forthwith (Standing Order No. 118(6)),

Value Added Tax

That the Value Added Tax (Distance Selling and Miscellaneous Amendments No. 2) Regulations 2021 (SI, 2021, No. 1165), dated 25 October 2021, a copy of which was laid before this House on 25 October, be approved.

Customs

That the Customs Tariff (Establishment and Suspension of Import Duty) (EU Exit) (Amendment) (No. 2) Regulations 2021 (SI, 2021, No. 1191), dated 26 October, a copy of which was laid before this House on 28 October, be approved.—(Mrs Andrea Jenkyns.)
Question agreed to.

BioYorkshire and the Bio-Economy

Motion made, and Question proposed, That this House do now adjourn.—(Mrs Andrea Jenkyns.)

Rachael Maskell: COP26 started a conversation that should have taken place decades previously. It did not end where our fragile planet demanded, but, with 1.5° now in critical care, it failed to grasp the scale of the crisis and it fell short of the demands required to safeguard against our planet burning, melting, flooding and people dying.
COP’s failure must be our call to revive the hope that our planet demands more acutely than ever before and that the global south depends on. It starts here.
COP26 said there is no time for delay, no time to prevaricate or put off, no time to postpone. When opportunity comes to accelerate our path to net zero, to cut carbon, to protect biodiversity, to end the plastic endemic, to enable a carbon negative future and to put investment in sustainability, it must be grasped. Delay has been our failure. To take action is our hope.
Madam Deputy Speaker, I am so grateful to you for allowing this debate tonight, on the heels of COP26—at the start of this new conversation, to give hope to our planet and to give hope to generations to come. Delay and prevarication are behind us; that era is over. The talking is done. The action is needed.
Tonight, that action is to institute BioYorkshire. As the CBI has said today, this is the very kind of project that the Government must invest in. I am expecting commitment from the Minister, I am expecting Government to realise the opportunity, and I am expecting investment in BioYorkshire and the biosciences. BioYorkshire is Yorkshire’s green new deal. It has been developed over the past two years, was seeded from years of research and applied application, and is already demonstrating the power of its science. It is a green industrial revolution waiting to scale up and level up.
BioYorkshire will place not only York and Yorkshire at the heart of the UK biosciences economy, but the UK at the heart of the global bio-economy. Its ambition is for domestic transition, but its power is in global mitigation. It will demonstrate how investment in biotechnology is hugely beneficial for our own economy, and on a global scale will give us new tools through which to drive international markets and international development. While the climate crisis drives our world apart and accelerates inequality, a just transition draws us together and demands equality: a time when global north reaches out to global south with the solutions they need to build their futures as we transition ours; and when we quicken the move to clean energy as we leave fossil fuels to rest in their carbon seams.
Let me set out the deal. BioYorkshire is a partnership of public and private. It is led by the University of York and is already delivering outstanding bioscience research with real-world impact of nature-based solutions. It is joined by Askham Bryan College—York’s agricultural college—and Fera Science Ltd. Its partners are then drawn from the food sector, the agricultural sector, digital and science, and the fuel, chemical and material industries. It will drive productivity and sustainability together across these footprints, developing new  technologies, and will be at the heart of many world-first breakthroughs in science across the agricultural and chemicals sectors: developing bio-packaging; mitigating methane; using insect and hemp-based technologies in agriculture and materials; upcycling and recycling. It will see the replacement of household waste, petrochemicals and fossil fuels with a new generation of bio-based products—cutting carbon, cutting waste and cutting climate challenges.
Yorkshire’s ambition to be net zero by 2038, as set out in the Yorkshire and Humber climate action plan, and for North Yorkshire to be the first carbon negative region, will rest on BioYorkshire being given the power to deliver. It will use world-class science and local expertise to turn lab technologies to fully scaled-up applications to deliver profitable, bio-based production of chemicals, materials and fuels, and enable productive, net zero food, feed, farming and wider land use practices.
As science and agricultural communities, and the food and tech sectors, look to BioYorkshire to inspire their futures, I say to the Government: if ever there was a project that could seed its levelling-up agenda in the region, BioYorkshire will deliver. This is where the power to the future economy sits. In its first phase, it will deliver 4,000 good-quality green collar jobs: engineers, biologists, agronomists, food technologists, chemists, natural capital economists, and robotic and digital experts—jobs so needed in the region. It will reskill and upskill 25,000 people, preparing them for a bright future in the green economy.
It does not end there. As the Minister will know, such well-prepared projects seed inward investment, attract global investment into centres of innovation, and therefore centre the bio-economy, bringing even greater green growth. From the Humber estuary to the farmlands of North Yorkshire, they are already committed to the project as it reaches out across Yorkshire, south and west. Such innovation will of course attract world-class scientists to our region who will further accelerate climate solutions under the British flag. It will be the place where future scientific leaders in the global south  will want to study to bring adaptation to their troubled land.
Springing from this first phase of BioYorkshire is the ambition to grow a network of specialised business incubators, training and skills, and entrepreneurial support to create and grow companies to commercially produce industrial and consumer products. BioYorkshire comprises three linked elements that combine to support innovation from concept to research to commercial reality. First, BioYorkshire’s innovation central will comprise world-leading science infrastructure and training for bio-economy entrepreneurs and innovators, including globally recognised research institutes. It will scale up opportunity and embed demonstrator facilities, including bio-economy skills and training centres, bringing researchers and businesses together to maximise opportunities for interaction and co-production. Secondly, BioYorkshire’s district incubator hubs located in urban, coastal and rural areas of York and North Yorkshire will link local bio-economy start-ups and business scale-ups with innovation and skills central, further seeding innovation. Thirdly, the BioYorkshire accelerator will provide advice, expertise, networks and promotional opportunities for businesses across the region, accelerating innovations from development to commercialisation.
From the investment the Government make—and I know the Minister will want to work with me and the partners to accelerate this—his colleagues in the Treasury will see around £1.4 billion gross value added within the Yorkshire region alone. As for our planet, in the UK, 2.8 million tonnes of carbon will disappear in emissions annually and landfill waste will be cut by 1.2 million tonnes, growing as technology is scaled. But York is not holding on to this opportunity; already reaching across Yorkshire, it is now extending to the industrial clusters of Humberside, Teesside and the north. It is truly a Northern powerhouse, but that power rests in the transition of our technology to not harm our planet as it once did, but to heal it.
The Minister will know that York is the gateway to the north, located equidistantly between the heart of Scotland’s scientific hub in Edinburgh and the power of the City of London, with just about the best-connected rail links the UK can boast. Adjacent, to the back of York station, lies Europe’s largest brownfield site, York Central. I know that the Government have much interest in the potential of this site. At this power point, BioYorkshire’s heart will beat, but its connectivity means that it will fast reach out to the region and nation. BioYorkshire is the bridge between the green new deal and levelling up. It has the reach, the connection—physical and digital; local and global—and the ambition.
Universities and colleges in partnerships with industry, science and research are at the very centre of shifting the dial for our future economy and sustaining our planet. The UK’s economic and skills future depends on the opportunities that research and development generate, drawing on the talents of workforces of today and tomorrow. It will be these skills that will innovate and accelerate economic renewal. This energised generation of young people will take on the old economic model of want and will supplant it with one of restoration of our planet. The demand for these jobs will be high, the opportunities over the next decade essential, if we are going to sustain a habitable planet and mitigate our past failings. BioYorkshire will accelerate this crucial transition and economic renewal through engaging businesses large and small to collaborate in research and development, to start and scale up new enterprises, and to work with schools, colleges and employers to nurture the talent the labour force needs across all  skill levels.
This is why I am so committed to delivering BioYorkshire. While everyone will say that York is a lovely place, and it is, if they look beyond the walls, they will see a generation whose industrial past has been stripped away, pride in place taken and skills supplanted by the insecure job market. I see my constituents struggle day by day. The de-industrialisation of York has been bitter and cruel. Its consequences: abject poverty, inadequate housing and inequality. This is why BioYorkshire means so much. It will inject skills, jobs and hope. It lights the dark recesses of York’s past and enables my constituents to renew their pride as they renew our planet. It is why I am on my feet today and why I am here in this place at all. Green-collar jobs really matter to my city of York. Our history, through the Rowntree revolution, laid the foundations for high ethical standards in work. Today, BioYorkshire marks the start of high ethical regeneration in our generation.
The Minister will be very alert to the innovation that Fera Science has driven from precision farming to cut the use of fertilisers to crop-resistant technologies. Domestically and globally, it has vastly advanced productivity and accelerated opportunity. As the climate heats, it will be the research from Fera Science’s partnership that will enable communities in the global south to be fed, to defeat infestations and crop disease and to resist scorching temperatures and flooded land. Askham Bryan College is at the cutting edge of digital farm technology, training young farmers to sustain their futures and sustain our planet.
The race for our planet is ultimately a moral pursuit. The industrial past which exploited this Earth’s assets, minerals and humans to generate wealth has now handed us the task of reparation. The consequences of failure are devastating; the responsibility weighs heavy. We cannot delay, Minister. We have to heal those scars, save those lives and repair this planet. I know the Minister understands; I know he will do all in his power to act.
A year ago, in response to my question at Prime Minister’s questions, the Prime Minister showed his support for BioYorkshire, recognising how it should benefit from his 10-point plan for a green industrial revolution. He said:
“I hope very much that BioYorkshire will be among the beneficiaries, and I cannot see any reason why it should not be.”—[Official Report, 25 November 2020; Vol. 684, c. 823.]
With the Prime Minister’s backing, the Government are already recognising the acceleration for BioYorkshire to be achieved through the North Yorkshire devolution deal, and I know that Departments such as the Minister’s, the Cabinet Office, the Department for Environment, Food and Rural Affairs and the Department for Education are already showing significant interest. We need action. The pain of COP tells us that we are still in this race against time; there can be no delay.
Will the Minister first make it his priority to come to York to meet the partners? I know that he will be keen to do so. Secondly, will he agree to make BioYorkshire one of his Government’s flagship projects and bring forward the full funding now, so that scaling can commence without delay? To have such a well-developed project could help accelerate the success of the Government’s 10-point plan and bring a crucial offering to COP27.
Commitment to funding is crucial. Partners are committed to multiplying its return. The price of this phase is just £171 million. The Prime Minister has said that BioYorkshire should be a beneficiary. The central economic forecast is that BioYorkshire will deliver a return on Government investment of 8.3 to 1. That far outstrips most of the Government’s infrastructure investments, as the Minister will know.
With COP26 done, the world is watching. Science, economy and ethics are yearning. The Prime Minister talks about a green industrial revolution; BioYorkshire is ready to lead that revolution. The Prime Minister talks about levelling up; BioYorkshire could deliver sustainable jobs and investment to the north right now. The Prime Minister said he would fund BioYorkshire. Will he keep that promise? The Government must see the opportunity, hear the need and feel the urgency to invest in Yorkshire’s green new deal. We cannot afford to delay.

George Freeman: It is genuinely a great pleasure, on this late Monday night, to respond to the hon. Member for York Central (Rachael Maskell), to pay tribute to her advocacy of the project and the wider cause that it embodies, and to take the opportunity to set out my personal support for the project’s aims. She would not expect me to say tonight that the cheque is in the post or to commit agencies that I cannot and should not commit.
In paying tribute to the hon. Lady’s advocacy, I will set out what the Government are trying to do overall in the area that she has highlighted. I will highlight some of the powerful elements of the bid and where they may fit into the emerging Government landscape. I would be delighted to visit as part of a programme of visits that I am doing around the country.
In the time available, I will try to set the scene. It is a great pleasure to be here as the newly appointed Minister for Science, Research and Innovation with a mission to implement the Prime Minister’s vision of a science superpower and an innovation nation. That means that the UK, in an increasingly competitive global world, has to continue to punch above its weight in science with world-class science and science for the global good that helps to prevent climate change, feed 9 billion hungry mouths and solve global challenges, as the hon. Lady has been talking about.
The innovation nation piece is about not just being good at science but building an ecosystem in the UK and making the UK a testbed or cluster globally for developing the new technologies that will help us to harness the renewable power of the sun and waves and the extraordinary power of bioscience, which is an area of particular interest and expertise of mine. Importantly, on the hon. Lady’s point, it is about ensuring that, as a nation, not only do we have world-class science in the golden triangle, but that we use our procurement and regulatory power to create clusters of new technologies around the country to create jobs and opportunities and a more resilient and fair economy, which is what the Government’s levelling-up mission is ultimately all about.
I suggest that the project speaks to all those challenges in a positive and helpful way. I pay tribute to the hon. Lady’s advocacy. She raised the issue with the Prime Minister last Monday, she spoke in the bio-economy debate, she spoke in the north of England: economic support debate, and she has spoken to me personally, so nobody could be doing more to promote it.
At the recent comprehensive spending review, the Chancellor set out a historic package of support for science and innovation. The country has spent more on science in the last 10 years than it has for decades. We have decided to increase that again in the next three years by 30%, from £15 billion to £20 billion a year, and we have recommitted to move to £22 billion a year  by ’27 on the journey to spending 2.4% of GDP. The Government are making important strategic long-term commitments.
Within the Department for Business, Energy and Industrial Strategy, post CSR, the Secretary of State and I are looking at where best to deploy those funds for maximum impact in terms of being a science superpower and an innovation nation. Fundamental to the innovation  nation piece, we will be looking to support clusters around the country. That will not be about trying to move world-class laboratories in Cambridge or Oxford to the north, which would not be sensible; the MRC Laboratory of Molecular Biology is one of our top laboratories partly because of where it is. It means ensuring that we support the clusters that are taking shape around the country, including the Yorkshire cluster that the hon. Lady talked about.
The hon. Lady knows my personal commitment to the bio-economy. Six years ago, when I was Minister for Life Sciences, I pushed the argument that life sciences should be a broader package of science of life, including the bio-economy and the appliance of bioscience across food, medicine and energy, and should look at how our understanding of biological systems can help to tackle global challenges. We have to feed 9 billion mouths and double world food production with the same land area and half as much water and energy, which is a big challenge. Which country in the world is best equipped to deal with that? This country, because of our agricultural science tradition. If we put together our digital expertise, our agri-tech and our bioscience, and start to invest in those multidisciplinary sciences, I would suggest that we have a huge opportunity to make a big global impact around the world.
Given a background in agriculture and agri-tech, having worked in the seeds industry and having the Norwich research park on my doorstep, I look at Fera, the leadership the hon. Lady has outlined powerfully in precision farming and in agri-tech, the University of York and the agriculture college. This is genuinely a cluster of excellence in its field. The bid it has put together around fuel, chemicals, materials, net zero, food and feed, and land use is a powerful one, and there is very little in it not to be supportive of.
This fits with what we set out in our innovation strategy earlier this summer. The hon. Lady will know that we have identified seven technologies of tomorrow that we want to support strategically. Two of them go right to the heart of this cluster: one in bio-engineering and synthetic biology, and one in genomics, including agricultural genomics for drought-resistant crops, disease-resistant crops and low-carbon farming. I also highlight that we are investing in the HEMP-30 project already through Innovate UK.
In the first half of this year, before returning to Government, I led a big piece of work for the Prime Minister looking at how we could use our regulatory freedoms on departure from the EU to support innovation. This was the taskforce on innovation, growth and regulatory reform report—or, Madam Deputy Speaker, the TIGRR report, if that trips off the tongue more easily—in which we identified 10 sectors where with very little regulatory leadership, and no need of primary legislation, we could unlock billions of investment.
Three of those sectors go to the heart of this bid. There is the agri-environment sector, and the importance of better science and the UK leading in the science of sustainability—the metrics of sustainable farming—so we can begin to label food so that consumers can see that this apple, potato or pint of milk has a low- carbon footprint, or a low-plastic, low-water footprint. It is that labelling that will drive empowered and enlightened consumers.
We also set out a series of recommendations about cannabinoid medicines, CBD and industrial hemp as a net-zero crop with huge potential, and the broader application of agri-genetics for both net zero agriculture and nutriceuticals, functional foods and the interaction of food and agricultural medicines.
There is very good landscape precedent, if I can put it that way, for the space in which this bid is being developed. It is for that reason as well that I am delighted to confirm that I would genuinely want to come up. I am organising a series of regional visits to support clusters, and I would hugely value coming up for a whole day and doing a series of visits around that cluster to help to support its development.
The hon. Lady will understand that we have a process internally now for allocating the CSR funds. There is a huge amount of work going on in my Department and others to set out a framework for that and make sure that it is criteria-led. She will understand that having an Adjournment debate is not a sufficient criterion as and of itself for making that decision, but she has made the case very powerfully.
I am pleased to see that the overall sum has come down from what was a very big number, which makes it harder to approve. I think that these things typically start small and grow and finding a good entry level is key to this project. I would also encourage her, as we discussed earlier, to make sure that the BBSRC supports this. I am sure it would. I cannot commit it, but I cannot think why it would not fit well in its overall structure—and, similarly, Innovate UK and UKRI. On that basis, I think this would stand a very good chance, which is actually—just to correct the record—what the Prime Minister said. I do not think that he actually committed to fund this. What he said was, as I have done, that it is a very strong case and one that it is quite difficult not to see a lot of merit in.
I would close by saying that, if we are going to create an innovation nation, yes, that is about strategic investment by Government in technologies, in institutes and in   buildings, but in the end it is about creating clusters. I suggest to the House, which I regret to say is not packed, that the best definition of a cluster is perhaps something that the hon. Lady, I and the representative on the Government Benches tonight, my hon. Friend the Member for Morley and Outwood (Andrea Jenkyns), can take away and share. For all the academic work on clusters, I suggest that the best definition of a cluster is a low-risk place to move one’s family to pursue a career in a high-risk sector. The conversation is, “Let’s move to Cambridge, Oxford, London, or Yorkshire because, darling, if this business does not work, there are plenty of others. The schools are good, the landscape is good and the quality of life is good—there is a cluster there.” In the end, the cluster normally comes to a mixture of public and private institutions, with entrepreneurship, innovation, support, and a shared vision, and that is what the bid sets out.
If we are to change the life chances of people around the country, it will be done through creating a different identity and a different sense of what this place is about. When we consider the institutions in that area, North Yorkshire is traditionally associated with the most beautiful countryside, wonderful tourism, great heritage and wonderful produce—who wouldn’t want to go on holiday to Yorkshire? However, not everyone can make a living in tourism, and the bid speaks to a bigger, bolder, more global, international higher-value economy for that part of the world, which I for one would be keen to support.
I am sorry that I cannot announce anything tonight—that is not my place at this point—but I am delighted to share with the hon. Lady that I would be delighted to come to visit and to continue to work with her and the partners on what looks like a very exciting bid for that part of the world.
Question put and agreed to.
House adjourned.